Ethnic differences in hypertension prevalence and contributing determinants – the HELIUS study

Abstract Aims There are important ethnic differences in the prevalence of hypertension and hypertension-mediated cardiovascular complications, but there is ongoing debate on the nature of these differences. We assessed the contribution of lifestyle, socio-economic and psychosocial variables to ethnic differences in hypertension prevalence. Methods We used cross-sectional data from the Healthy Life In an Urban Setting (HELIUS) study, including 21,520 participants aged 18–70 years of South-Asian Surinamese (n = 3032), African Surinamese (n = 4124), Ghanaian (n = 2331), Turkish (n = 3594), Moroccan (n = 3891) and Dutch (n = 4548) ethnic origin. Ethnic differences in hypertension prevalence rates were examined using logistic regression models. Results After adjustment for a broad range of variables, significant higher hypertension prevalence compared to the Dutch population remained in Ghanaian men (odds ratio 2.62 (95% confidence interval 2.14–3.22)) and women (4.16 (3.39–5.12)), African Surinamese men (1.62 (1.37–1.92)) and women (2.70 (2.29–3.17)) and South-Asian Surinamese men (1.22 (1.15–1.46)) and women (1.84 (1.53–2.22)). In contrast, Turkish men (0.72 (0.60–0.87)) and Moroccan men (0.50 (0.41–0.61)) and women (0.57 (0.46–0.71)) had a lower hypertension prevalence compared with the Dutch population. The differences in hypertension prevalence were present across different age groups and persisted after stratification for body mass index and waist-to-hip ratio. Conclusion Large ethnic differences in hypertension prevalence exist that are already present in young adulthood. Adjustment for common variables known to be associated with a higher risk of hypertension explained the higher adjusted prevalence rates among Turks and Moroccans, but not in African and South-Asian descent populations who remained to have a higher rate of hypertension compared to the Dutch host population.