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Effect of Weight on Blood Pressure Greater in Lean Whites Than in Blacks

Bruce Goldfarb

Weight has a greater effect on lean whites' blood pressure than on that of lean blacks—a difference that progressively narrows with increasing degrees of overweight and obesity, according to research presented at the American Society of Hypertension (ASH) annual meeting, held May 14–18 in San Francisco.

Daniel T. Lackland, MD, and colleagues at the Medical University of South Carolina, Charleston, S.C., compared data from the Black Pooling Project, which consists of nine cohort studies including 8,920 black women, 7,175 black men, 27,606 white women, and 37,413 white men. Participants were followed for 8–30 years between 1960 and 1995.

After researchers controlled for age, cholesterol, smoking status, and other factors, every unit increase in body mass index (BMI) was associated with an increase of 0.43 mmHg in systolic blood pressure in black women, 1.01 mmHg in white women, 0.29 mmHg in black men, and 0.79 mmHg in white men.

Although blacks had a higher systolic blood pressure than whites at all BMI levels, the differences evened out at the upper range of BMI. According to the researchers, the mean systolic blood pressures for black men and women were "virtually all in the hypertension range," while among whites such high pressures were noted in women with a BMI of 30.5 and men with a BMI of 32.5.

"As you get larger your blood pressure goes up, in blacks and in whites," Lackland says. "But in lean people, the effects of weight on systolic blood pressure are greater in whites than in blacks."

Primary care clinicians should consider drug therapy for hypertension along with suggesting dietary changes such as the Dietary Approaches to Stop Hypertension (DASH) diet, the researchers suggest (see FYI).

"You really need to consider the diet, and not just for weight control," Lackland says. "The DASH diet works. Telling a patient to lose weight may not be enough, particularly for blacks."

Footnotes

FYI

The Dietary Approaches to Stop Hypertension (DASH) eating plan is derived from the DASH clinical study. The research was funded by the National Heart, Lung, and Blood Institute (NHLBI), with additional support by the National Center for Research Resources and the Office of Research on Minority Health, all units of the National Institutes of Health (NIH). The results show that the DASH "combination diet" lowered blood pressure, and therefore may help prevent and control high blood pressure.

The diet is rich in fruits, vegetables, and low-fat dairy foods, and low in saturated and total fat. It also is low in cholesterol, high in dietary fiber, potassium, calcium, and magnesium, and moderately high in protein.

For more information visit www.nih.gov/news/pr/apr97/Dash.htm.

Source: Appel LJ, Moore TJ, Obarzanek E, et al. for the DASH Collaborative Research Group: A clinical trial of the effects of dietary patterns on blood pressure, N Engl J Med 336:1117–1124, 1997.

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Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Goldfarb, B. Search for Related Content PubMed Articles by Goldfarb, B. Social Bookmarking                What's this?