The natural history of blood pressure in black populations in the West Indies, West Africa and the UK: a comparison with the USA

Abstract

This chapter reviews the natural history of blood pressure (BP) in black populations in the West Indies, West Africa, and the United Kingdom. The earliest prevalence studies of BP in the Caribbean were those in the United States Virgin Islands. Average BP levels by age group were higher for blacks than whites, but social class differed markedly. A similar pattern among black residents of the Bahamas was confirmed in a censused urban study there. The definitive work on BP in the West Indies was the longitudinal survey of the censused community of Lawrence Tavern, a semirural village 16 miles outside Kingston, Jamaica. This cohort study was the first in a black population anywhere and was started in 1958 in an MRC unit. Total response rates were over 95%, except for urban men, and response rates with verified ages were over 75% for rural and 65% for urban subjects. BPs were similar to those measured in Wales although the upper tails of their frequency distributions were longer in women for diastolic BP. Temperature may have been a confounding factor and therefore, comparisons have to be guarded. The rural Jamaican women had higher pressures than urban, contrary to findings in West Africa.