title: Country of birth affects blood pressure in the French hypertensive diabetic population.
abstract: In a population of 56,242 individuals living in France, we showed that individuals born in France have significantly different levels of blood pressure (BP) and cardiovascular (CV) risk factors than African and Asian populations born in their own country but living long-term in France (average duration of stay, 5-10 years). The objective of our study was to investigate the impact of country of birth on BP and CV risk factors in a subpopulation of 9245 patients selected solely on the diagnosis of hypertension, either alone or with simultaneous type 2 diabetes. In the subgroup of individuals with hypertension alone, brachial systolic, diastolic, mean and pulse pressure (PP), heart rate (HR), augmentation index and PP amplification were significantly higher in African-born than French- and Asian-born populations. In the subgroup of individuals with both hypertension and diabetes, only augmentation index, PP amplification and brachial and central PP, but not brachial systolic, diastolic, mean BP, and HR, were elevated when the African-born subgroup was compared to the French- and Asian-born populations. Increased body mass index (BMI), waist-hip ratio (WHR), and deprivation scores, but not increased plasma lipids or glycemia, were consistently associated with the African-born population. The combination of diabetes and hypertension in African populations was associated with increased aortic stiffness and PP, together with greater body weight and WHR. In individuals with increased PP and hence systolic hypertension, increased PP requires systolic BP to be reduced whereas notable reductions in diastolic BP may have deleterious consequences.
authors.affiliation: Lebanese American University Medical Center Beirut, Lebanon.
authors.forename: Sola
authors.initials: S
authors.lastname: Aoun Bahous
authors.affiliation: Centre d'Investigations Préventives et Cliniques (IPC) Paris, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Thomas
authors.affiliation: Centre d'Investigations Préventives et Cliniques (IPC) Paris, France ; Institut National de la Santé et de la Recherche Médicale U 970, Hôpital Manhès Fleury-Mérogis, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pannier
authors.affiliation: Centre d'Investigations Préventives et Cliniques (IPC) Paris, France ; Cardiology Department, Hôpital Européen Georges-Pompidou, Université Paris-Descartes Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
authors.affiliation: AP-HP, Diagnostic and Therapeutic Center, Paris Descartes University Hôtel-Dieu, Paris, France.
authors.forename: Michel E
authors.initials: ME
authors.lastname: Safar
keywords: aortic stiffness; country of birth; diabetes mellitus; ethnicity; hypertension; wave reflection