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Management of hypertension in ethnic minorities
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  1. Jawad M Khan,
  2. D Gareth Beevers
  1. University Department of Medicine, City Hospital, Birmingham, UK
  1. Correspondence to:
    Dr Jawad M Khan
    University Department of Medicine, City Hospital, Birmingham B18 7QH, UK; jawad.khanswbh.nhs.uk

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Hypertension, currently defined as a blood pressure > 140 mm Hg (systolic) and/or > 90 mm Hg (diastolic), is a common problem. In a western adult population the prevalence of hypertension exceeds 20%.1 The prevalence of hypertension increases with age and is higher in ethnic minority groups in the UK. In the Health Survey for England (2001) the prevalence of hypertension was 3.3% in those aged < 40 years, 27.9% in those aged between 40–79 years, and 49.9% in those aged 80 years and older.2

The two main ethnic origin groups within the UK are the Afro-Caribbean and South Asians. The majority of studies have reported a higher prevalence and significantly higher mean blood pressure levels among both Afro-Caribbean populations and South Asians compared to their white counterparts.3 In a south London community based study, compared with whites, age and sex standardised prevalence ratios for hypertension were 2.6 in people of African descent and 1.8 in those of South Asian origin.4 However, average blood pressure varies between different subgroups of South Asians, being highest in Sikhs, similar to whites in Muslims, and intermediate in Hindus.5 In addition, Indians have higher blood pressures, Pakistanis lower blood pressures, with Bangladeshis having even lower blood pressures than the native white population.6

CONSEQUENCES OF HYPERTENSION FOR ETHNIC MINORITIES

Hypertension is a major risk factor for cardiovascular and cerebrovascular disease, the major causes of death in the UK and other western countries. Recent studies indicate substantial ethnic differences in cardiovascular mortality.7 For example, compared to whites, Afro-Caribbean and people of African descent have a higher incidence of stroke8 and end stage renal failure,9 whereas coronary artery disease is less common. Conversely, South Asians (defined as people originating from the Indian subcontinent and East Africa) have a higher incidence of coronary heart disease. …

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