title: Divergence with age in blood pressure in African-Caribbean and white populations in England: implications for screening for hypertension.
abstract: BACKGROUND
  We assessed when blood pressure (BP) and hypertension begin to rise in African-Caribbeans compared to the white population; and whether the change relates to body mass index (BMI).
  
  
  METHODS
  Secondary analysis of the cross-sectional Health Surveys for England among 22,723 participants (21,344 whites and 1,379 African-Caribbeans) adults aged ≥18 years.
  
  
  RESULTS
  The cubic spline graphs showed a crossover (African-Caribbean greater than whites) at 30-40 years in BP. Age-specific mean BP and hypertension prevalence data showed at 20-29 years African-Caribbean men were advantaged but not thereafter. There was little difference in BMI in men. African-Caribbean women had lower systolic BP (but higher prevalence of hypertension) at 20-29 years but higher BP and prevalence of hypertension thereafter. African-Caribbean women had higher BMI than white women. Regression showed an age and ethnicity interaction for systolic (0.076 mm Hg greater increase per year, P = 0.054) and diastolic BP (0.068 mm Hg greater increase per year (P = 0.009) and hypertension (OR equals 1.02, P = 0.004) in African-Caribbean men, and diastolic BP in African-Caribbean women (0.057 mm Hg greater increase per year, P = 0.017). Crossover was 28, 44, and 28 years for systolic BP, diastolic BP and hypertension in men, respectively; and 40 years for diastolic BP in women.
  
  
  CONCLUSIONS
  Clinicians should be extra vigilant about screening African-Caribbean patients from the age of 30 years. Detailed study is needed to understand the still mysterious mechanisms for this crossover.
authors: Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. c.o.agyemang@amc.uva.nl
authors: Charles
authors: C
authors: Agyemang
authors: Roger W
authors: RW
authors: Humphry
authors: Raj
authors: R
authors: Bhopal
mesh_terms: D000328:Adult; D000367:Age Factors; D044383:Black People / Q000706:statistics & numerical data; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D015992:Body Mass Index; D017691:Caribbean Region / Q000208:ethnology; D004739:England / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D044465:White People / Q000706:statistics & numerical data