Hypertension, Vol 22, 90-96, Copyright © 1993 by American Heart Association
N Chaturvedi, PM McKeigue and MG Marmot
To investigate why mortality from stroke in people of Afro-Caribbean origin
is twice the average for England and Wales, we examined 1166 European and
Afro-Caribbean people in London. Age-standardized median systolic blood
pressure was 6 mm Hg higher (128 versus 122 mm Hg) in Afro-Caribbean than
European men and 17 mm Hg higher (135 versus 118 mm Hg) in Afro-Caribbean
than European women. Migrants from West Africa and the Caribbean had
similar blood pressures. Body mass index was higher in Afro-Caribbean than
European women, accounting for 4 mm Hg of the systolic difference. Diabetes
prevalence was 16% in Afro-Caribbeans and 5% in Europeans (P < .001),
accounting for 1 mm Hg of the difference in systolic pressure in men and 2
mm Hg in women. In participants not taking antihypertensive medication,
mean fall in ambulatory systolic pressure between daytime and nighttime,
adjusted for resting blood pressures, was 24 mm Hg in Europeans and 18 mm
Hg in Afro-Caribbeans (P = .05), and percent day-night fall in systolic
blood pressure adjusted for resting systolic pressure was 17% in Europeans
and 12% in Afro-Caribbeans (P < .05). This difference persisted when men
and women and normotensive and hypertensive individuals were examined
separately. We estimate that the differences in blood pressure between
Afro-Caribbeans and Europeans may be enough to account for ethnic
differences in stroke mortality in women but not men. The reasons for the
high prevalence of hypertension and related morbidity in this and other
populations of African descent remain to be established.
ARTICLES
Resting and ambulatory blood pressure differences in Afro-Caribbeans and Europeans
Department of Epidemiology and Public Health, University College and Middlesex School of Medicine, London, England.
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