Abstract Body: Background: There are preventable disparities in blood pressure (BP) levels by race in the US, that contribute to a higher rate of cardiovascular disease (CVD) events and mortality among non-Hispanic Black compared to non-Hispanic White US adults. We estimated the number of CVD events and CVD deaths that could be prevented among non-Hispanic Black adults by achieving the same mean systolic BP (SBP) as non-Hispanic White adults ≥45 years of age.
Methods: We calculated the difference in mean SBP between non-Hispanic Black versus White US adults and the number of non-Hispanic Black US adults from the National Health and Nutrition Examination Survey 2015-2020. The 10-year cumulative incidence of CVD, including stroke, coronary heart disease, or heart failure, and CVD mortality for non-Hispanic Black adults was calculated using data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. We applied the relative risk reduction for CVD events and CVD mortality with initiation and intensification of antihypertensive medication from the Blood Pressure Lowering Treatment Trialists Collaboration, calibrated to reflect the SBP reduction for non-Hispanic Black adults to have the same SBP as non-Hispanic White adults.
Results: Among non-Hispanic Black and White US adults, mean SBP was 130.7 (95%CI 129.0-132.5) and 124.2 (95%CI 123.1-125.3) mmHg for those not taking antihypertensive medication (difference 6.5 mmHg; 95%CI 4.5-8.5), respectively, and 137.8 (95%CI 135.8-139.8) and 131.2 (95%CI 129.7-132.7) mmHg for those taking antihypertensive medication (difference 6.5 mmHg; 95%CI 4.0-9.1), respectively. Achieving equity in SBP between non-Hispanic Black and White adults was projected to reduce the number of CVD events over 10 years by 50,434 (95%CI 33,985-71,137) among non-Hispanic Black US adults not taking antihypertensive medication and 122,881 (95%CI 83,220-176,826) among non-Hispanic Black adults taking antihypertensive medication. Equity in SBP between non-Hispanic Black and White adults was projected to reduce the number of CVD deaths over 10 years by 21,702 (95%CI 7,313-40,278) among non-Hispanic Black US adults not taking antihypertensive medication and 55,055 (95%CI 19,823-99,693) among non-Hispanic Black adults taking antihypertensive medication.
Conclusions: Achieving SBP equity between non-Hispanic Black and White adults may substantially reduce the number of CVD events and deaths experienced by non-Hispanic Black adults.