The study, the largest of its kind to compare the development of hypertensive emergencies in a United States inner city, appears in the journal Blood Pressure.

One in three adults has high blood pressure, known as hypertension, with the highest rates among African Americans. In addition to being very common, high blood pressure in Black Americans develops earlier in life but has lower control rates compared to other racial and ethnic groups. Higher-than-average blood pressure leads to serious health complications. The study aimed to determine the prevalence and risk factors of high blood pressure escalating to severe cases among African Americans.

“Extremely high blood pressure rates are an alarming and significant health concern for the African-American population,” says Irina Benenson, an assistant professor in the Rutgers University School of Nursing.

“Developing targeted interventions to control for the major risk factors may reduce the risk of drastic increases in blood pressure and thus reduce the risk of organ damage as a result.”

Patients who were male, 65 years or older, or who had diabetes, chronic heart disease, or kidney disease were at the highest risk for developing extremely high blood pressure.

Researchers analyzed medical records of 3,568 patients with elevated blood pressure treated in the emergency department of Newark Beth Israel Medical Center, a New Jersey hospital that serves predominantly African-American communities. Half of these patients had severe increases in blood pressure.

The results showed that patients who were male, 65 years or older, or who had diabetes, chronic heart disease, or kidney disease were at the highest risk for developing extremely high blood pressure, which lead to potentially life-threatening complications such as worsening congestive heart failure and heart attack. Researchers also found these patients were at a significantly higher risk for developing kidney failure, stroke, and a ruptured blood vessel in the brain known as hemorrhagic stroke.

According to the researchers, this was also the first study to identify low hemoglobin as a risk factor for severely elevated blood pressure.

“Anemia is common in people with high blood pressure, especially in those who have diabetes or kidney disease. Low hemoglobin was found to contribute to a severe rise in blood pressure, but further studies are needed to fully explain the associate between the two,” says Benenson.

The study highlights alarming rates of severely elevated blood pressure in African-Americans and suggests that treatments to control diabetes, chronic heart and kidney disease, and anemia may reduce the development of an extremes in blood pressure and related serious complications.

While psychosocial stress African Americans sometimes face such as occupational stress, housing instability, social isolation, and racism were not within the scope of this specific study, Benenson believes that these could be a few factors that can contribute to higher rates of blood pressure in African Americans.

“These factors occur more often in African Americans than in other racial groups, and it is proposed that chronic stress can activate stress hormones that constrict blood vessels and elevate blood pressure. However, more studies are needed to confirm.”

Source: Rutgers University