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Racial and ethnic differences in blood pressure: biology and sociology.

In the last few years, much attention has been given to racial and ethnic differences in health measures. Not surprisingly, much of the work in this area is being done in the United States. Not only does our unique racial and ethnic diversity offer opportunities for study, but the social and political issues related to this diversity have driven a need to understand the disparities in health related to these differences.

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These racial and ethnic differences in health measures are seen clearly in cardiovascular disease risk factors and outcomes for Americans of African descent, or African Americans (AAs), compared with those of European descent, or European Americans (EAs). Compared with EAs, AAs have higher mortality rates for most cardiovascular diseases, including coronary heart disease and stroke. These differences are magnified at younger ages.1

Prevalence rates for key risk factors differ for AAs, with higher rates for hypertension, obesity, and diabetes mellitus, and lower rates for dyslipidemia. Additionally, the cardiovascular consequences imposed by various risk factors differ by race. Compared with hypertensive EA men and women and AA men, AA women with hypertension have a substantially greater relative risk for heart disease. Conversely, AA women have a substantially lower relative risk for diabetes mellitus than EA women.2

The disparities in cardiovascular outcome are large and significant, and the disparities in outcome have worsened in the last 2 decades.3 Appropriately, much attention is being given to understanding these differences.

For a number of years, this important area of study was hampered by a lack of interest and a lack of funding. Now that a commitment is being made in this area, other challenges of understanding the causes of these differences are becoming clearer. The science is complex.3

The challenges to understanding the science of racial …