Lang T
INSERM U258, Hôpital Broussais, Paris.
Presse Med. 1994 Nov 19;23(36):1642-5.
High blood pressure in black subjects has been recognized as a clinical entity because of high prevalence, frequent severe complications and pathophysiological and therapeutic specificities. Results from 52 centers in 32 countries show wide variability. In the black population in United States, mean systolic and diastolic blood pressure levels are high, 128/81 mmHg, with a prevalence of hypertension reaching 33.5%, while an ethnic population in Kenya has low mean levels, 110/68 mmHg, with a hypertension prevalence of only 5%. Complications have been reported to be more frequent in black populations. In the United States, in comparison with the white population morbidity due to left ventricular hypertrophy is increased by 2, end-stage renal failure by 4.2 and mortality due to cerebral vascular diseases by 1.5. However, risk factors including over-weight, alcohol consumption, sodium intake and the socioeconomic environment have been shown to explain most of the differences between the white and the black populations. Differences in diagnosis and management may also play a role. Indeed, while genetic selection may have had an effect, there is no current scientific data which would justify using the colour of the skin as a genetic marker for high blood pressure.
由于高血压在黑人中患病率高、严重并发症频繁以及病理生理和治疗方面的特殊性,黑人高血压已被视为一种临床实体。来自32个国家52个中心的结果显示出很大的差异。在美国黑人人群中,平均收缩压和舒张压水平较高,为128/81 mmHg,高血压患病率达到33.5%,而肯尼亚的一个种族人群平均水平较低,为110/68 mmHg,高血压患病率仅为5%。据报道,并发症在黑人人群中更为常见。在美国,与白人相比,黑人因左心室肥厚导致的发病率增加2倍,终末期肾衰竭增加4.2倍,脑血管疾病导致的死亡率增加1.5倍。然而,包括超重、饮酒、钠摄入和社会经济环境在内的风险因素已被证明可以解释白人和黑人人群之间的大部分差异。诊断和管理方面的差异也可能起作用。的确,虽然基因选择可能产生了影响,但目前尚无科学数据证明可以将肤色作为高血压的基因标记。