Blood pressure control and mortality in US- and foreign-born blacks in New York City

J Clin Hypertens (Greenwich). 2017 Oct;19(10):956-964. doi: 10.1111/jch.13045. Epub 2017 Jul 6.

Abstract

This retrospective cohort study compared blood pressure (BP) control (BP <140/90 mm Hg) and all-cause mortality between US- and foreign-born blacks. We used data from a clinical data warehouse of 41 868 patients with hypertension who received care in a New York City public healthcare system between 2004 and 2009, defining BP control as the last recorded BP measurement and mean BP control. Poisson regression demonstrated that Caribbean-born blacks had lower BP control for the last BP measurement compared with US- and West African-born blacks, respectively (49% vs 54% and 57%; P<.001). This pattern was similar for mean BP control. Caribbean- and West African-born blacks showed reduced hazard ratios of mortality (0.46 [95% CI, 0.42-0.50] and 0.28 [95% CI, 0.18-0.41], respectively) compared with US-born blacks, even after adjustment for BP. BP control rates and mortality were heterogeneous in this sample. Caribbean-born blacks showed worse control than US-born blacks. However, US-born blacks experienced increased hazard of mortality. This suggests the need to account for the variations within blacks in hypertension management.

Keywords: clinical management of high blood pressure; hypertension; hypertension in blacks; vascular disease.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Black People / ethnology
  • Black or African American / ethnology
  • Blood Pressure / drug effects*
  • Blood Pressure / physiology
  • Blood Pressure Determination / methods*
  • Caribbean Region / ethnology
  • Comorbidity
  • Ethnicity
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / mortality
  • Male
  • Middle Aged
  • Mortality / ethnology*
  • Mortality / trends
  • New York City / ethnology
  • Prevalence
  • Retrospective Studies
  • United States / epidemiology

Substances

  • Antihypertensive Agents