MUSC researchers find more evidence of major racial health disparities

Heather Woolwine

Oct. 26, 2011

MUSC researchers find more evidence of major racial health disparities

Lifestyle-change efforts to reduce hypertension disparities having limited success

CHARLESTON -- MUSC researchers have found that blacks have a 35 percent higher risk of developing new onset of high blood pressure compared with whites, even after adjustment for age, sex, baseline systolic and dialostic blood pressures, body mass index, diabetes, and chronic kidney disease.

This disparate progression to higher blood pressure among blacks is at least one year earlier than whites. The findings of this study led by Anbesaw Selassie, DRPH., MUSC biostatistics and epidemiology associate professor, and his colleagues were published in the American Heart Association’s online Hypertension journal Oct. 12. For the full article, visit:

Prehypertension is a major risk factor for hypertension. Blacks have more prevalent and severe hypertension than whites, but it was unknown prior to this study whether progression from prehypertension to hypertension was also accelerated in blacks. In finding that the conversion from prehypertension to hypertension is accelerated in blacks, researchers suggest that effective interventions in prehypertension could reduce racial disparities in prevalent hypertension.

The study examined almost 19,000 people (5733-black, 13,132 white, aged 18-85 years) through the Outpatient Quality Improvement Network Hypertension Initiative database. Electronic health record data were obtained from 197 community-based outpatient clinics in the southeastern US.

"This [accelerated levels of prehypertension] creates a strong disadvantage. I firmly believe this finding is very important because eliminating the intensity of hypertension among blacks is the ‘low hanging fruit’ in reducing health disparities between the races," Selassie said. Further, he noted that the findings may help to explain some of the underlying differences between blacks and whites in terms of cardiovascular disease, such as earlier mortality due to stroke among blacks.

Public-health efforts during the past 20 years mainly focused on lifestyle change with limited success in reducing racial differences in prevalent hypertension, and, according to Selassie, something new has to be explored. "While lifestyle intervention that begins before high blood pressure begins is commendable and important, the possibility of intervening with medicine at an earlier stage in blacks with prehypertension may need to be considered," Selassie said. "These medicines are cheap and safe costing about $9 to get a 30-day supply of a generic preparation. Tangible and fundamental answers must be forthcoming as to why the black population develops hypertension more frequently and rapidly and how it can be prevented."

About MUSC

Founded in 1824 in Charleston, The Medical University of South Carolina is the oldest medical school in the South. Today, MUSC continues the tradition of excellence in education, research, and patient care. MUSC educates and trains more than 3,000 students and residents, and has nearly 11,000 employees, including 1,500 faculty members. As the largest non-federal employer in Charleston, the university and its affiliates have collective annual budgets in excess of $1.7 billion. MUSC operates a 750-bed medical center, which includes a nationally recognized Children's Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), and a leading Institute of Psychiatry. For more information on academic information or clinical services, visit or