Guidelines on hypertension: comparison between countries on ethnic specific statements8,41–58
Category | Type of statement | Statement about ethnic differences | Country | Evidence | Strength |
---|---|---|---|---|---|
*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. | |||||
Epidemiology | Empirical | Higher prevalence, more severe and higher risk for complications | USA | Klag (1997)41 | IIb |
Burt (1995)42 | III | ||||
Fang (1996)43 | III | ||||
Singh (1996)44 | III | ||||
Havas (1996)45 | IV* | ||||
Hall (1997)46 | IV* | ||||
UK | Balarajan (1991)56 | III | |||
McKeigue (1991)57 | III | ||||
Cappuccio (1997)8 | III | ||||
Williams (1995)58 | IV | ||||
Treatment | Empirical | Difference in response to pharmacological treatment | USA | Townsend (1990)47 | Ib |
SOLVD (1991)48 | Ib | ||||
Materson (1993)49 | Ib | ||||
Chen (1993)50 | IIa | ||||
Chen (1995)51 | IIa | ||||
UK | Materson (1993)49 | Ib | |||
Empirical | Hypertension is sensitive to dietary salt restriction in black subjects | USA | Weinberger (1996)52 | IV* | |
UK | No reference | – | |||
Empirical | Lifestyle modifications are particularly important | USA | No reference | – | |
Recommendation | Black subjects require multi-drug therapy because of more severe hypertension | USA | Burt (1995)42† | III | |
Hall (1997)46† | IV* | ||||
Recommendation | Achieve goal blood pressure of below 140/90 mm Hg | USA | Burt (1995)42† | III | |
Hall (1997)46† | IV* | ||||
Recommendation | Emphasis on glucose tolerance, lipids and increased coronary risk | UK | McKeigue (1991)57 | III | |
Williams (1995)58 | IV | ||||
Recommendation | Good blood pressure control important in South Asians with diabetes | UK | No reference | – | |
Recommendation | Aspirin and/or statin treatment may be indicated for South Asians at high risk of CHD | UK | No reference | – | |
Recommendation | The start of drug therapy should be influenced by black race | CAN | No reference | – | |
Patient education | Empirical | Requirement of more focused education | USA | Enas (1996)53 | III |
Howard (1996)54 | III | ||||
Winkleby (1996)55 | III | ||||
Havas (1996)45 | IV* | ||||
Recommendation | Advice to reduce fat and refined sugar intake and to increase exercise | UK | No reference | – |