PRELIMINARY REPORT: BLOOD PRESSURE TRAJECTORIES OVER TIME IN A MULTI-ETHNIC POPULATION

Abstract

Objective: Objective: Hypertension remains the leading cause of cardiovascular diseases worldwide. Major interethnic differences in the prevalence of hypertension exist. Exploring blood pressure (BP) levels in a large prospective multi-ethnic population provides insight in interethnic differences in blood pressure trajectories across the life course. Design and method: Design and method: We examined BP course over time in participants from the HEalthy Life in an Urban Setting (HELIUS) study. Participants aged 18–70 years from Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin with BP data at baseline and follow-up were included. BP levels were corrected for the use of antihypertensive medication. BP change over time was expressed as delta systolic blood pressure (delta SBP) and delta diastolic blood pressure (delta DBP). Multivariate regression analyses were performed to assess the association between ethnicity and BP levels at follow-up, with correction for sex, age, follow-up time, change of BMI and blood pressure levels at baseline. Results: Results: In total 8.053 participants (mean age 46.2 (12.4) years, 43.8% female) were included. Median follow-up time was 6.2 (5.3–7.1) years. Overall there was a slight increase in SBP over time (129.41 mmHg at baseline vs. 129.87 at follow-up), while diastolic blood pressure levels tended to decrease (delta DBP = -0.59 mmHg) (Figure 1). The highest SBP increase was found in the Ghanaian population (+1.84 mmHg), while the largest decrease was observed in in the Dutch population (-0.28 mmHg). The lowest DBP decrease was found in the Ghanaian population (-0.02 mmHg) and the highest decrease in the South-Asian Surinamese population (-1.31 mmHg). Multivariable regression analysis showed a strong association between ethnicity and SBP at follow-up, especially for the Ghanaian population (β = 5.51 (95%CI 4.42 – 6.61), p = 2.2e-16) compared to the Dutch reference population. For DBP these interethnic differences were also present, but less pronounced. Conclusions: Conclusions: Major interethnic differences in the course of blood pressure over time were found, with substantially higher SBP levels in the Ghanaian population compared to the reference Dutch population.