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Is the blood pressure of people from African origin adults in the UK higher or lower than that in European origin white people? A review of cross-sectional data

Abstract

The aim of the study was to review published evidence on whether blood pressure (BP) levels and the prevalence of hypertension are higher in adult populations of African descent living in the UK as compared to the white population. A systematic literature review was carried out using MEDLINE 1966–2002 and EMBASE 1980–2002 and citations from references. In all, 14 studies were identified. Nearly all studies were carried out in the London area. The data showed important differences between studies in terms of age and sex of samples, definition of African/black and methods of evaluating BP. A total of 10 studies reported higher mean systolic BPs, while 11 studies reported higher mean diastolic BPs in men from African descent compared to white men. In women, 10 of 12 studies reported higher systolic, and 10 of 12 studies reported higher diastolic BPs. For prevalence of hypertension, eight of 10 studies reported higher rates in men from African descent; eight of nine studies showed higher rates of hypertension in women from African descent. Overall, the most representative sample and up-to-date data came from the Health Survey for England '99. Ethnic group differences in BP were not present in the younger age groups. Women of African descent had higher BP and higher body mass index (BMI). In men of African descent high BP did not coincide with higher BMI. In conclusion, the reported higher rates of hypertension in people from African descent in the UK are confirmatory of the USA African-American and white comparisons. Variations in study methods, size and body composition, and in the mix of Afro-Caribbean and West African groups explain much of the inconsistent results in the UK studies.

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Acknowledgements

We thank A de Jonge for her valuable advice throughout this work, S Sengupta-Wiebe for her advice during the initial literature search and Hazel King for secretarial support. We also thank Dr Kennedy Cruickshank and Dr Nishi Chaturvedi for their useful comments and Dr Lisa Riste for supplying unpublished data. We thank the anonymous referee, who provided comments that helped improve an earlier version of this paper.

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Correspondence to Raj Bhopal.

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Glossary of ethnicity termsIn extracting information from the original papers, whenever appropriate, we have taken the terms used by the authors.

Ethnicity—refers to the group individuals belong to as a result of their culture, which includes language, religion, diet, and ancestry.2

Ethnic minority group—refers to minority non-European non-white populations.

White people—refers to people with European ancestral origin.

Black people—refers to people with African ancestral origin.

Afro-Caribbean—refers to people, and their offspring, with African ancestral origin but migrating to Britain via the Caribbean islands.

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Agyemang, C., Bhopal, R. Is the blood pressure of people from African origin adults in the UK higher or lower than that in European origin white people? A review of cross-sectional data. J Hum Hypertens 17, 523–534 (2003). https://doi.org/10.1038/sj.jhh.1001586

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