Hypertension in Blacks

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Abstract
The excess of hypertension among blacks has been recognized since early in this century and explains a substantial portion of the black health disadvantage. In a cohort study begun in the 1970s, hypertension accounted for 20% of all-cause mortality among blacks, compared to 10% among whites. National data on trends in hypertension (140/90 mm Hg or treatment) prevalence from 1960 to 1990 suggest a decline from 44% to 32%, although differences in survey technique likely account for this pattern. During this period the prevalence ratio of black:white remained constant at 1.5, suggesting that secular trends in causal factors, if any, effected both groups equally. Recent data demonstrate a gradient in risk across the African diaspora, with standardized prevalences of 14% in West Africa and 26% in the Caribbean, compared to 33% in the US. This pattern parallels the gradient in known risk factors, with obesity alone accounting for a third of the excess in the US compared to Africa.

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