Strict blood pressure management and heart health: Does ethnicity play a role?

This study investigated if the improvement in cardiac health using strict blood pressure management was different between race and ethnicity.

They found that there was no difference in cardiac outcomes between patients of different ethnicities.

Hypertension (high blood pressure) is a serious condition that can cause cardiovascular disease (CVD) and increase the risk of death. Previous standard of care recommended that doctors and patients should aim to reduce blood pressure to below 140 mmHg systolic. In recent years, it has been suggested that strict blood pressure management may reduce the chance of negative outcomes (e.g. disability, death).

The SPRINT study was a clinical trial conducted to determine if strict blood pressure control (less than 120 mmHg systolic) was more beneficial to patients. It is not clear whether ethnicity plays a role in outcomes.

This report investigated if strict blood pressure management leading to improved cardiovascular outcomes was affected by race and ethnicity.

This study included over 9,000 patients with hypertension. Patients were assigned to two groups: intensive blood pressure control and standard blood pressure control. Patients were monitored for an average of 3.26 years. The number of cardiovascular-related events including heart attack, stroke, heart failure and death were recorded. For this analysis, patients were sub-divided into groups based on ethnicity and race – Non-Hispanic Black (NHB), Non-Hispanic White (NHW) or Hispanic.

Patients on intensive blood pressure control had a reduced number of cardiovascular events and death. The risk of cardiovascular events was similarly reduced in all patients under intensive control: -30% NHW, -29% NHW and -38% Hispanics. Death rates were also similarly reduced in patients under intensive control. Kidney function was also similar across the sub-groups. The number of serious adverse events was not different between ethnic/racial groups. 

This study concluded that there was no difference in cardiac outcomes between patients of different ethnicities.

Classification of ethnicity is not always straightforward. A person’s ethnicity may be mixed and if classified inappropriately it may impact the analysis. 

If you have any concerns regarding blood pressure management, please consult with your doctor.