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Hypertension: How Race Affects Risk

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African Americans Face Higher Risk of Hypertension

Nearly half of all adults in the U.S. are living with high blood pressure (also known as hypertension). That adds up to an estimated 103 million people. Even more startling, research has shown that the onset and severity actually vary by ethnicity. Specifically, African Americans in the U.S. have among the highest rates of hypertension in the world. Not only do they tend to develop the condition earlier in life, but they also experience more severe symptoms and risks, from stroke and heart disease to blindness and dementia.

To further investigate this pattern, researchers looked at nearly 4,000 participants who had previously enrolled in a study called Coronary Artery Risk Development in Young Adults (CARDIA). The individuals ranged from ages 18 to 30 years when they first enrolled in CARDIA and had no signs of high blood pressure. By the time they turned 55 years old, research could be gathered and revealed the percentage of those who developed hypertension:

  • 75.5% of black men,
  • 75.7% of black women,
  • 54.5% of white men
  • 40.0% of white women

Data also showed that regardless of blood pressure levels in young adulthood, African Americans still have a significantly higher risk for hypertension compared with Caucasians through 55 years of age. With such a discrepancy in percentages, it begs the question, “Why? Why is high blood pressure in African-Americans much more common?”

The reasons have yet to be pinpointed. Researchers believe that the relationship between African Americans and early-onset hypertension could be a combination of nature and nurture factors, from genetic predispositions to socioeconomic causes.

Genetic factors

The earlier onset and high rates of hypertension for African Americans could be a result of their genetic makeup. In research studies, African Americans in the U.S. responded differently to high blood pressure drugs than other races (source). There may also be a gene that makes their bodies more sensitive to salt and therefore retains more sodium — a contributing factor in raising blood pressure levels.

Environmental factors

Environmental differences, including lower socioeconomic status, poor nutrition, and access to healthy foods can also be a contributor. Additionally, poor nutrition and access to care for pregnant women can result in low infant birth weight, which has been linked to a higher risk of hypertension in adulthood (source).

While the causes of hypertension may still remain unclear, the disparity and risks are undeniable. Higher blood pressure levels are associated with increased rates of stroke, congestive heart failure, and end-stage renal disease. Women with hypertension also face a higher risk of dementia and Alzheimer’s.

Intervention is key

According to S. Justin Thomas, Ph.D., an assistant professor in the Department of Psychiatry at the University of Alabama at Birmingham, “It is urgent that healthcare providers counsel young patients, particularly blacks, about eating a healthy diet, being physically active and controlling body weight.” However, it’s not a catch-all solution and treating high blood pressure isn’t a one-size-fits-all approach, especially for individuals who may not respond to hypertension medications.

Because research has shown that African Americans have a lower response rate to blood pressure medications, this line of treatment may not be as effective for some. For those who haven’t responded to BP medication, alternative therapies, such as clinical trials, may be able to help control blood pressure long term.

At Rox Medical, we are working to help individuals of all ethnicities with hypertension that hasn’t responded to medication or lifestyle modifications manage their uncontrolled high blood pressure. This is achieved through a device therapy called the ROX Flow Procedure and is currently enrolling qualified candidates in the CONTROL HTN-2 Clinical trial. The trial is designed to study the effectiveness of the ROX Coupler, a dime-sized stent placed in the upper thigh through a minimally invasive procedure that creates a small passageway from the artery to the vein. This allows high-pressured blood from the iliac artery to flow into the lower-pressured iliac vein in your pelvis. By shifting a modest amount of arterial blood flow to the venous system, individuals with uncontrolled hypertension may be able to see a decrease in their blood pressure.

While the racial disparities in hypertension and its risks have significant effects for African Americans, prevention programs, lifestyle changes, and alternative therapies may help manage it long term as well as fill in the gaps in research. In fact, many advanced medical solutions today are direct results from successful clinical trials. If you are interested in learning more about the CONTROL HTN-2 Clinical trial or want to see if you’re eligible to participate, see our requirements here. Be a part of making history with us and help reduce your risk of hypertension-related diseases.

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