Donald Clark III (Trey) MD, MPH recently published the article “Population Attributable Risk for Cardiovascular Disease Associated with Hypertension in Black Adults” in JAMA Cardiology. Read the full article here. Dr. Clark tells us about the paper, its findings and potential impact on healthcare in Mississippi.
What gaps in knowledge do these findings fill? What gaps still persist?
This represents one of the largest studies to evaluate the population impact of hypertension on cardiovascular health in black adults in the US. We used data from 2 large cohort studies, including >13,000 black adults, and the National Health and Nutrition Examination Survey (NHANES) to estimate the population attributable risk of cardiovascular disease associated with hypertension. Our findings demonstrate that nearly one in three cardiovascular events are associated with hypertension in this population. Further work is needed to evaluate strategies to reduce blood pressure at a population level.
What are some of the unique risk factors for hypertension-related cardiovascular disease in black adults?
The prevalence of hypertension and hypertension-related cardiovascular disease are higher among black adults compared to other racial/ethnic groups. While this study did not directly address risk factors for developing hypertension, it has been shown that interventions such as regular physical activity, weight control, and a heart healthy diet prevent the development of hypertension.
Were these findings surprising to you? Why?
The impact of hypertension on cardiovascular disease among black adults is significant, although our findings are largely consistent with smaller prior studies. Perhaps most striking, is the population attributable risk of 69% for stroke associated with hypertension among those aged <60 years. These findings highlight the importance of preventing and treating hypertension among younger adults to reduce the burden of cardiovascular disease, primarily stroke.
What additional research is needed?
Hypertension is a major public health issue, and this study supports the need to prioritize resources for this condition. Our study supports further investigation and evaluation of policies to reduce blood pressure at a population level, such as public health interventions to increase physical activity, reduce dietary sodium intake, and ensure access to effective diagnosis and treatment.