Ethnic differences in hypertension prevalence and contributing determinants - the HELIUS study

Eur J Prev Cardiol. 2018 Dec;25(18):1914-1922. doi: 10.1177/2047487318803241. Epub 2018 Oct 9.


Aims: There are important ethnic differences in the prevalence of hypertension and hypertension-mediated cardiovascular complications, but there is ongoing debate on the nature of these differences. We assessed the contribution of lifestyle, socio-economic and psychosocial variables to ethnic differences in hypertension prevalence.

Methods: We used cross-sectional data from the Healthy Life In an Urban Setting (HELIUS) study, including 21,520 participants aged 18-70 years of South-Asian Surinamese ( n = 3032), African Surinamese ( n = 4124), Ghanaian ( n = 2331), Turkish ( n = 3594), Moroccan ( n = 3891) and Dutch ( n = 4548) ethnic origin. Ethnic differences in hypertension prevalence rates were examined using logistic regression models.

Results: After adjustment for a broad range of variables, significant higher hypertension prevalence compared to the Dutch population remained in Ghanaian men (odds ratio 2.62 (95% confidence interval 2.14-3.22)) and women (4.16 (3.39-5.12)), African Surinamese men (1.62 (1.37-1.92)) and women (2.70 (2.29-3.17)) and South-Asian Surinamese men (1.22 (1.15-1.46)) and women (1.84 (1.53-2.22)). In contrast, Turkish men (0.72 (0.60-0.87)) and Moroccan men (0.50 (0.41-0.61)) and women (0.57 (0.46-0.71)) had a lower hypertension prevalence compared with the Dutch population. The differences in hypertension prevalence were present across different age groups and persisted after stratification for body mass index and waist-to-hip ratio.

Conclusion: Large ethnic differences in hypertension prevalence exist that are already present in young adulthood. Adjustment for common variables known to be associated with a higher risk of hypertension explained the higher adjusted prevalence rates among Turks and Moroccans, but not in African and South-Asian descent populations who remained to have a higher rate of hypertension compared to the Dutch host population.

Keywords: Healthy Life In an Urban Setting; Hypertension; ethnicity; obesity; prevalence.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Asian People* / psychology
  • Black People* / psychology
  • Blood Pressure
  • Cross-Sectional Studies
  • Female
  • Health Status Disparities*
  • Health Surveys
  • Humans
  • Hypertension / diagnosis
  • Hypertension / ethnology*
  • Hypertension / physiopathology
  • Life Style / ethnology
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Sex Distribution
  • Social Determinants of Health / ethnology
  • Socioeconomic Factors
  • White People / psychology
  • Young Adult