Gender disparities in hypertension among different ethnic groups in Amsterdam, The Netherlands: the SUNSET study.
BACKGROUND
Studies have consistently shown a lower prevalence of hypertension in women than in men. Obesity is an important risk factor for hypertension, and the rate of obesity is particularly high among ethnic minority women. It is therefore questionable whether the lower prevalence of hypertension in women is also true among specific ethnic minority groups in Europe. Hence, we sought to determine whether gender disparity in hypertension is consistent across different ethnic groups, and if not so, whether differences in body sizes (body mass index (BMI) and waist circumferences) explain demonstrated gender disparities in hypertension among different ethnic groups in Amsterdam, the Netherlands.


METHODS
The SUNSET study was a random sample of 1,432 people aged 35-60 years (508 White-Dutch, 591 African-Surinamese, and 333 Hindustani-Surinamese).


RESULTS
Age-adjusted hypertension rate was significantly lower in White-Dutch women than in White-Dutch men as expected--the odds ratio (95% confidence interval) was 0.35 (0.23-0.54). This difference hardly changed after adjustment for body sizes and other factors. However, among the ethnic minority groups, age-adjusted hypertension rate did not differ significantly between women and men in both African-Surinamese 0.74 (0.51-1.08) and Hindustani-Surinamese 0.80 (0.49-1.29). It was only after further adjustment for body sizes that African-Surinamese women were significantly less likely than African-Surinamese men to have hypertension 0.54 (0.36-0.81). The same pattern applied to the Hindustani-Surinamese, although less pronounced 0.59 (0.34-1.02).


CONCLUSIONS
Gender differences in hypertension are not consistent across ethnic groups. The lack of differences in ethnic minority groups is related to lifestyle factors particularly overweight and obesity.
Agyemang
Charles
C
Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. c.o.agyemang@amc.uva.nl
de Munter
Jeroen
J
van Valkengoed
Irene
I
van den Born
Bert-Jan
BJ
Stronks
Karien
K
D000328:Adult; D005006:Ethnicity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D015995:Prevalence; D012737:Sex Factors