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Methods Papers

National Heart, Lung, and Blood Institute–Initiated Program "Interventions to Improve Hypertension Control Rates in African Americans"

Background and Implementation

Paula T. Einhorn, MD, MS

From the Division of Prevention and Population Sciences, National Heart, Lung, and Blood Institute, Bethesda, Md.

Correspondence to Paula T. Einhorn, MD, MS, Division of Prevention and Population Sciences, 2 Rockledge Centre, Room 10222, 6701 Rockledge Dr, MSC 7936, Bethesda, MD 20892-7936. E-mail einhornp@mail.nih.gov

Key Words: hypertension • clinical trials, randomized • cardiovascular diseases • prevention & control • risk factors

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Hypertension affects more than 70 million adults in the United States and nearly one billion globally.^1,2 Blacks have been long recognized to have the highest prevalence and the earliest onset of hypertension. Hypertension is also a major contributor to the racial gap in cardiovascular mortality between whites and blacks—more than 2-fold for ages 35 to 64, and for men this gap has increased since 1960.³

	Background

 
National and Regional Surveillance
In 2002, Wong et al estimated cause-specific risks of death from the National Health Interview Survey conducted from 1986 through 1994 and from linked vital statistics (a national probability sample of more than 600 000 individuals) according to education level and race.⁴ They identified hypertension as the single initiating cause of death independent of socioeconomic status that contributed the most to the racial disparity in potential life-years lost between blacks and whites.

At the same time, the National Health and Nutrition Examination Survey (NHANES) 1999 to 2000 data became available to National Heart, Lung, and Blood Institute (NHLBI) staff. These data revealed low rates of blood pressure (BP) control in treated non-Hispanic blacks, in addition to a long-recognized high prevalence of hypertension defined as BP >140/90 mm Hg or treated. As shown in Figure 1, 1 of 5 black men age 30 to 39 had hypertension (compared with 1 of 8 white and Hispanic men the same age). Although the prevalence rates for women aged 30 to 39 were relatively low for all race/ethnic groups (6% to 9%), by age 40 to 49, nearly . . . [Full Text of this Article]

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