Higher Blood Pressure May Increase Risk of Heart Failure, Death in African Americans

Higher Blood Pressure May Increase Risk of Heart Failure, Death in African Americans

Higher blood pressure, which can lead to chronic kidney disease (CKD), may increase the risk of heart failure and death among African-American adults of all ages, according to new research.

The study, “Associations Between Blood Pressure And Outcomes Among Blacks In The Jackson Heart Study,” was published in the Journal of the American Heart Association.

In 2014, the eighth Joint National Committee (JNC) issued new recommendations for managing high blood pressure in adults. One was an increase in the recommended blood pressure level in people 60 and older without CKD or diabetes — from less than 140/90 mm Hg to less than 150/90 mm Hg. The committee is an arm of the US National Institutes of Health.

The Association of Black Cardiologists and the Working Group on Women’s Cardiovascular Health expressed concern about the new recommendation because high blood pressure in African Americans increases the risk of death from heart disease, CKD and stroke.

“Given that blood pressure targets are not attained in up to 50 percent of clinical practice, providers may want to proceed cautiously when liberalizing these targets in a group at higher risk of all the (related) effects of hypertension, such as heart attack, stroke, and chronic kidney disease,” Tiffany Randolph, MD, lead author of the study, said in a news release.

Researchers analyzed information on 5,289 African American patients in the Jackson Heart Study between 2000 and 2011. The goal was to see if higher blood pressure was associated with greater risk of heart-failure hospitalization and death across all age groups. The median period used for follow-up was seven years for hospitalization and nine years for death.

The findings were that the risk of hospitalization and death from heart failure increased with every 10 mm Hg increase in blood pressure. The risk of death associated with each 10-mm-Hg increase in blood pressure was higher among patients under 60 (26 percent) than among those 60 or older (10 percent).

“This observational study should make us question whether the current JNC guidelines have identified the optimal target for blood pressure control in the African American population,” Randolph said. “To fully answer this question, we will need additional large, randomized, controlled trials that enroll a diverse population. Until then, providers will have to continue assessing risk and working with patients to set blood pressure goals based on all the available data and individual patient concerns.”


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