Table 2

Guidelines on hypertension: comparison between countries on ethnic specific statements8,41–58

CategoryType of statementStatement about ethnic differencesCountryEvidenceStrength
*Narrative reviews.
†There was no reference mentioned for this particular statement in the guideline, but because this statement is based on information about risk factors (high prevalences), it is probably based on the evidence about a higher prevalence in certain ethnic groups.
EpidemiologyEmpiricalHigher prevalence, more severe and higher risk for complicationsUSAKlag (1997)41IIb
Burt (1995)42III
Fang (1996)43III
Singh (1996)44III
Havas (1996)45IV*
Hall (1997)46IV*
UKBalarajan (1991)56III
McKeigue (1991)57III
Cappuccio (1997)8III
Williams (1995)58IV
TreatmentEmpiricalDifference in response to pharmacological treatmentUSATownsend (1990)47Ib
SOLVD (1991)48Ib
Materson (1993)49Ib
Chen (1993)50IIa
Chen (1995)51IIa
UKMaterson (1993)49Ib
EmpiricalHypertension is sensitive to dietary salt restriction in black subjectsUSAWeinberger (1996)52IV*
UKNo reference–
EmpiricalLifestyle modifications are particularly importantUSANo reference–
RecommendationBlack subjects require multi-drug therapy because of more severe hypertensionUSABurt (1995)42†III
Hall (1997)46†IV*
RecommendationAchieve goal blood pressure of below 140/90 mm HgUSABurt (1995)42†III
Hall (1997)46†IV*
RecommendationEmphasis on glucose tolerance, lipids and increased coronary riskUKMcKeigue (1991)57III
Williams (1995)58IV
RecommendationGood blood pressure control important in South Asians with diabetesUKNo reference–
RecommendationAspirin and/or statin treatment may be indicated for South Asians at high risk of CHDUKNo reference–
RecommendationThe start of drug therapy should be influenced by black raceCANNo reference–
Patient educationEmpiricalRequirement of more focused educationUSAEnas (1996)53III
Howard (1996)54III
Winkleby (1996)55III
Havas (1996)45IV*
RecommendationAdvice to reduce fat and refined sugar intake and to increase exerciseUKNo reference–