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Brachial BP underestimates vascular burden in African Americans
19 November 2008
MedWire News: Young and healthy African-American men have a high prevalence of undetected hypertension and subclinical cardiovascular disease, new research suggests.
The study, by a team at the University of Illinois in Chicago, USA, found increased central blood pressure (BP) and vascular dysfunction in a sample of young African-American men, none of whom had raised BP by conventional brachial measurement.
Kevin Heffernan and fellow investigators studied 25 African-American and 30 White men who were all aged 23 years with no known cardiovascular, metabolic, renal, or respiratory disease. None of the men smoked or used over-the-counter analgesic or anti-inflammatory drugs.
The study, which is reported in the American Journal of Physiology–Heart and Circulatory Physiology, found no differences between African-American and White participants in height, weight, body mass index, body fat, blood lipids, glucose, white cell count, or family history of diabetes/hypertension.
Furthermore, there were no differences between the groups in stroke volume or cardiac output or in brachial systolic BP, diastolic BP, pulse pressure, or mean arterial pressure.
However, African-American men had significantly greater systolic BP measured at the carotid artery (129 vs 129 mm Hg, p=0.007) and aorta (112 vs 106 mm Hg, p=0.02).
African-American men also had significantly greater carotid intima-media thickness and carotid ß-stiffness indices and significantly lower peak hyperemic forearm blood flow following ischemia compared with White men.
Heffernan et al say this is the first study to examine racial differences in central BP and contains several novel findings.
“Our results support the notion that brachial BP does not reflect vascular burden, particularly in young healthy African-American men, and alterations in central pressure may precede alterations in brachial pressure,” they write.
“Thus measurement of central BP, vascular stiffness, and or intima-media thickness may fill a crucial void in current management of hypertension and related sequelae in African Americans.”
