Race-based Therapy for Hypertension: Possible Benefits and Potential Pitfalls

Keith C. Ferdinand; Daphne P. Ferdinand

Disclosures

Expert Rev Cardiovasc Ther. 2008;10(6):1357-1366. 

In This Article

Hypertension in Asian Individuals

The incidence of hypertension in Asian-Americans does not appear to be significantly higher than the general population, according to limited US data. On the other hand, south Asians (Asian-Indians) have an increased CHD risk, potentially related to the metabolic syndrome, primarily due to insulin resistance, truncal obesity and dyslipidemia in the USA.[55] When present, high BP with excessive abdominal obesity may markedly increase cardiovascular risks seen in Asian-Americans. Moreover, in the Indian subcontinent, hypertension is a major public health concern, and among south Asians living in Western societies, the prevalence of hypertension, along with CHD, will potentially increase with time. Some explanation of the various hypertension rates among Asian populations may be related to sodium intake and decreased physical activity. Overall, data are limited in regard to pharmacological therapy, but antihypertensive agents appear to be as effective in Asians as Whites. Nevertheless, ACEIs appear to be possibly associated with increased cough and angioedema in East Asians.[56,57]

Overall, non-American epidemiological studies show that South Asians experience high rates of hypertension. Cardiovascular disease contributed to 2.3 million deaths in India in 1990 and is projected to double by the year 2010.[58] Hypertension is directly responsible for 57% of stroke deaths and 24% of CHD deaths in India.[58] In an evaluation of multiple examinations in various Indian populations, there appear to be higher levels in urban versus rural subjects, with a strong correlation between changing lifestyle factors and the increase in hypertension in India.[58]

Data related to hypertension in American Indians/Alaskan natives, Native Hawaiians and other Pacific Islanders are even more limited. Prevalence appears to be low for hypertension, although overall rates of CVD may be increased in some of these subpopulations.

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