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Panethnic Differences in Blood Pressure in Europe: A Systematic Review and Meta-Analysis

Author

Listed:
  • Pietro Amedeo Modesti
  • Gianpaolo Reboldi
  • Francesco P Cappuccio
  • Charles Agyemang
  • Giuseppe Remuzzi
  • Stefano Rapi
  • Eleonora Perruolo
  • Gianfranco Parati
  • ESH Working Group on CV Risk in Low Resource Settings

Abstract

Background: People of Sub Saharan Africa (SSA) and South Asians(SA) ethnic minorities living in Europe have higher risk of stroke than native Europeans(EU). Study objective is to provide an assessment of gender specific absolute differences in office systolic(SBP) and diastolic(DBP) blood pressure(BP) levels between SSA, SA, and EU. Methods and Findings: We performed a systematic review and meta-analysis of observational studies conducted in Europe that examined BP in non-selected adult SSA, SA and EU subjects. Medline, PubMed, Embase, Web of Science, and Scopus were searched from their inception through January 31st 2015, for relevant articles. Outcome measures were mean SBP and DBP differences between minorities and EU, using a random effects model and tested for heterogeneity. Twenty-one studies involving 9,070 SSA, 18,421 SA, and 130,380 EU were included. Compared with EU, SSA had higher values of both SBP (3.38 mmHg, 95% CI 1.28 to 5.48 mmHg; and 6.00 mmHg, 95% CI 2.22 to 9.78 in men and women respectively) and DBP (3.29 mmHg, 95% CI 1.80 to 4.78; 5.35 mmHg, 95% CI 3.04 to 7.66). SA had lower SBP than EU(-4.57 mmHg, 95% CI -6.20 to -2.93; -2.97 mmHg, 95% CI -5.45 to -0.49) but similar DBP values. Meta-analysis by subgroup showed that SA originating from countries where Islam is the main religion had lower SBP and DBP values than EU. In multivariate meta-regression analyses, SBP difference between minorities and EU populations, was influenced by panethnicity and diabetes prevalence. Conclusions: 1) The higher BP in SSA is maintained over decades, suggesting limited efficacy of prevention strategies in such group in Europe;2) The lower BP in Muslim populations suggests that yet untapped lifestyle and behavioral habits may reveal advantages towards the development of hypertension;3) The additive effect of diabetes, emphasizes the need of new strategies for the control of hypertension in groups at high prevalence of diabetes.

Suggested Citation

  • Pietro Amedeo Modesti & Gianpaolo Reboldi & Francesco P Cappuccio & Charles Agyemang & Giuseppe Remuzzi & Stefano Rapi & Eleonora Perruolo & Gianfranco Parati & ESH Working Group on CV Risk in Low Res, 2016. "Panethnic Differences in Blood Pressure in Europe: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-21, January.
    • Handle: RePEc:plo:pone00:0147601
    DOI: 10.1371/journal.pone.0147601
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    1. Teshager Weldegiorgis Abate & Balew Zeleke & Ashenafi Genanew & Bidiru Weldegiorgis Abate, 2021. "The burden of stroke and modifiable risk factors in Ethiopia: A systemic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(11), pages 1-19, November.
    2. Lucía Ramírez Martínez-Acitores & Fernando Hernández Ruiz de Azcárate & Elisabeth Casañas & Julia Serrano & Gonzalo Hernández & Rosa María López-Pintor, 2020. "Xerostomia and Salivary Flow in Patients Taking Antihypertensive Drugs," IJERPH, MDPI, vol. 17(7), pages 1-16, April.
    3. Md Nuruzzaman Khan & Melissa L. Harris & Desalegn Markos Shifti & Alexander Suuk Laar & Deborah Loxton, 2019. "Effects of unintended pregnancy on maternal healthcare services utilization in low- and lower-middle-income countries: systematic review and meta-analysis," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(5), pages 743-754, June.
    4. Siti Idayu Hasan & Anne Yee & Ariyani Rinaldi & Adlina Aisya Azham & Farizah Mohd Hairi & Amer Siddiq Amer Nordin, 2021. "Prevalence of common mental health issues among migrant workers: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-21, December.
    5. S. Wilson Beckham & Norah L. Crossnohere & Margaret Gross & John F. P. Bridges, 2021. "Eliciting Preferences for HIV Prevention Technologies: A Systematic Review," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(2), pages 151-174, March.
    6. Nefsu Awoke & Henok Mulgeta & Tsegaye Lolaso & Tiwabwork Tekalign & Serawit Samuel & Mohammed Suleiman Obsa & Robera Olana, 2020. "Full-dose hepatitis B virus vaccination coverage and associated factors among health care workers in Ethiopia: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-15, October.
    7. Shilpa Aggarwal & George Patton & Nicola Reavley & Shreenivas A Sreenivasan & Michael Berk, 2017. "Youth self-harm in low- and middle-income countries: Systematic review of the risk and protective factors," International Journal of Social Psychiatry, , vol. 63(4), pages 359-375, June.

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