Ethnic differences in hypertension incidence among middle-aged and older adults: the multi-ethnic study of atherosclerosis.
Ethnic differences in hypertension incidence among middle-aged and older adults: the multi-ethnic study of atherosclerosis.
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DOI：
10.1161/hypertensionaha.110.168005
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发表时间：
2011-06
期刊：
影响因子：
--
通讯作者：
Muntner P
中科院分区：
文献类型：
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作者：
Carson AP;Howard G;Burke GL;Shea S;Levitan EB;Muntner P
非裔美国人的高血压患病率高于白人。然而，关于中年和老年非裔美国人和白人的高血压发病率报告的结果不一致，关于美国西班牙裔和亚洲人高血压发病率的数据有限。因此，本研究调查了来自动脉粥样硬化多种族研究的3，146名参与者的年龄特异性高血压发病率。基线时年龄为45-84岁的参与者，对高血压事件（定义为收缩压≥ 140 mmHg，舒张压≥ 90 mmHg或开始使用降压药物）进行中位随访4.8年。高血压的粗发病率，每1,000人-年，白人为56.8，非洲裔美国人为84.9，西班牙裔美国人为65.7，中国人为52.2。在调整年龄、性别和研究地点后，45-54岁的非洲裔美国人的高血压发病率比（IRR）增加（IRR=2.05，95% CI=1.47，2.85），55-64（IRR=1.63，95% CI=1.20，2.23）和65-74岁（IRR=1.67，95% CI=1.21，2.30），但对于75-84岁的患者（IRR=0.97，95% CI=0.56，1.66）。对健康特征的额外调整减弱了这些关联。与白人相比，西班牙裔参与者的高血压发病率也更高;然而，中国和白色参与者的高血压发病率没有差异。总之，在45岁至74岁之间，非裔美国人的高血压发病率高于白人，但在75岁之后则不然。需要针对中年和老年人的公共卫生预防计划，以消除高血压发病率的种族差异。
The prevalence of hypertension is higher among African-Americans than whites. However, inconsistent findings have been reported on the incidence of hypertension among middle-aged and older African-Americans and whites and limited data are available on the incidence of hypertension among Hispanics and Asians in the US. Therefore, this study investigated the age-specific incidence of hypertension by ethnicity for 3,146 participants from the Multi-Ethnic Study of Atherosclerosis. Participants, age 45–84 years at baseline, were followed for a median of 4.8 years for incident hypertension, defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or the initiation of antihypertensive medications. The crude incidence rate of hypertension, per 1,000 person-years, was 56.8 for whites, 84.9 for African-Americans, 65.7 for Hispanics, and 52.2 for Chinese. After adjustment for age, gender, and study site, the incidence rate ratio (IRR) for hypertension was increased for African-Americans age 45–54 (IRR=2.05, 95% CI=1.47, 2.85), 55–64 (IRR=1.63, 95% CI=1.20, 2.23), and 65–74 years (IRR=1.67, 95% CI=1.21, 2.30) compared with whites, but not for those 75–84 years of age (IRR=0.97, 95% CI=0.56, 1.66). Additional adjustment for health characteristics attenuated these associations. Hispanic participants also had a higher incidence of hypertension compared with whites; however, hypertension incidence did not differ for Chinese and white participants. In summary, hypertension incidence was higher for African-Americans compared with whites between 45 and 74 years of age but not after age 75 years. Public health prevention programs tailored to middle-age and older adults are needed to eliminate ethnic disparities in incident hypertension.