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Ethnic Differences in Associations Between Blood Pressure and Stroke in South Asian and European Men.

Eastwood, SV; Tillin, T; Chaturvedi, N; Hughes, AD; (2015) Ethnic Differences in Associations Between Blood Pressure and Stroke in South Asian and European Men. Hypertension , 66 (3) pp. 481-488. 10.1161/HYPERTENSIONAHA.115.05672. Green open access

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Abstract

It is unknown whether associations between blood pressure (BP) and stroke vary between Europeans and South Asians, despite higher stroke rates in the latter. We report findings from a UK cohort study of 1375 European and 1074 South Asian men, not receiving antihypertensive medication, aged 40 to 69 years at baseline (1988-1991). Assessment included BP, blood tests, anthropometry, and questionnaires. Incident stroke was established at 20 years from death certification, hospital and primary care records, and participant report. South Asians had higher systolic BP, diastolic BP, and mean arterial pressure than Europeans, and similar pulse pressure. Associations between systolic BP or diastolic BP and stroke were stronger in South Asians than Europeans, after adjustment for age, smoking status, waist/hip ratio, total/high-density lipoprotein-cholesterol ratio, diabetes mellitus, fasting glucose, physical activity, and heart rate (systolic BP: Europeans [odds ratio, 1.22; 95% confidence interval, 0.98-1.51], South Asians [1.56; 1.24-1.95]; ethnic difference P=0.04; diastolic BP: Europeans [0.90; 0.71-1.13], South Asians [1.68; 1.32-2.15]; P<0.001). Hemodynamic correlates of stroke risk differed by ethnicity: in combined models, mean arterial pressure but not pulse pressure was detrimentally associated with stroke in South Asians, whereas the converse was true for Europeans. The combination of hyperglycemia and hypertension appeared particularly detrimental for South Asians. There are marked ethnic differences in associations between BP parameters and stroke. Undue focus on systolic BP for risk prediction, and current age and treatment thresholds may be inappropriate for individuals of South Asian ancestry.

Type: Article
Title: Ethnic Differences in Associations Between Blood Pressure and Stroke in South Asian and European Men.
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1161/HYPERTENSIONAHA.115.05672
Publisher version: http://dx.doi.org/110.1161/HYPERTENSIONAHA.115.056...
Language: English
Additional information: Copyright © 2015 by American Heart Association, Inc. All rights reserved. Unauthorized use prohibited.
Keywords: blood pressure, diabetes mellitus, fasting glucose, heart rate, stroke, Adult, Aged, Asian Continental Ancestry Group, Blood Pressure, Cohort Studies, Comorbidity, European Continental Ancestry Group, Humans, Hyperglycemia, Hypertension, Incidence, Male, Middle Aged, Stroke, Waist-Hip Ratio
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
URI: https://discovery.ucl.ac.uk/id/eprint/1471453
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