Hispanics hypertension

Izhar M, Alausa T, FoUcer A, Hung E, Bakris GL. Effects of COX inhibition on blood pressure and kidney function in ACE inhibitor-treated blacks and hispanics. Hypertension (2004) 43, 573-7. 

The prevalence of hypertension differs based on age, sex, and ethnicity. As individuals become older, their risk of high blood pressure increases. Individuals 55 years of age who do not have hypertension are estimated to have a lifetime risk of 90% of eventually developing hypertension. The National Health and Nutrition Examination Survey from 1999 to 2000 indicated that hypertension is slightly more prevalent in men (30.1%) than women (27.1%). However, the prevalence increased by 5.6% in women and has remained unchanged in men from 1988 to 2000.5 Hypertension prevalence is highest in African-Americans when compared to non-Hispanic whites and Mexican-Americans.1... 

Non-modifiable risk factors include age, gender, race/ ethnicity, and heredity. Ischemic stroke risk is increased in those greater than 55 years of age, in men, and in African-Americans, Hispanics, and Asian-Pacific Islanders. It is also increased in those with a family history of stroke. Modifiable risk factors include a number of treatable disease states and lifestyle factors that can greatly influence overall stroke risk. Hypertension is... 

Cardiovascular Effects. There is currently considerable scientific debate as to whether there is a causal relationship between lead exposure and hypertension. Another area of controversy is whether African Americans are more susceptible to the cardiovascular effects of lead than are whites or Hispanics. The evidence from both occupational studies and large-scale general population studies (i.e., National Health and Nutrition Examination Survey [NHANES II], British Regional Heart Study [BRHS]) is not sufficient to conclude that such a causal relationship exists between PbB levels and increases in blood pressure. The database on lead-induced effects on cardiovascular function in humans will be discussed by presenting a summary of several representative occupational studies followed by a discussion of the findings from the large-scale general population studies. 

Schmidt-Nowara WW, Coultas DB, Wiggins C, Skipper BE, Samet JM. Snoring in a Hispanic-American population risk factors and association with hypertension and other morbidity. Arch Intern Med 1990 150(3) 597-601. 

On the other hand, some diseases for which African Americans are at greater risk, such as hypertension and stroke, may be made worse by a low intake of calcium. Average intake of calcium in African American, Hispanic, and Asian populations are at the threshold (600-700 mg/day) below which bone loss and hypertension can result. Though many members of these groups are lactase nonpersistent, intolerance symptoms can be reduced to acceptable levels with commonsense dietary practices that still allow sufficient intake of dairy products for health. Partial reduction of national health disparities between ethnic groups may be possible by overcoming the barrier of lactose intolerance (Jarvis and Miller, 2002). 

CCT as a Function of Race, Age, and Disease. Average CCT varies with race (Box 34-1), age, and diagnosis. Whites, Chinese, Hispanics, and Filipinos tend to have comparable CCTs. Among the Asian races, Mongolians have the thinnest CCT, whereas the Japanese have thinner corneas than Chinese and Filipinos. African-Americans, patients with glaucoma, and older patients tend to have thinner corneas. Patients with ocular hypertension tend to have thicker corneas. 

The following numbers speak for themselves, and I present them without commentary or fearmongering. Statistics from the American Heart Association in 2006 show that 65 million men and women in the United States have high blood pressure, defined as systolic pressure of 140 or greater and/or diastolic pressure of 90 or more. In the white population, 20.5 percent have hypertension, while that percentage jumps to 31.6 for African Americans. Nineteen percent of Hispanics and 16.1 percent of Asians have hypertension. 

A 42-year-old Hispanic woman, with end-stage renal disease, anemia, hypertension, and a history of an anaphylactic reaction to basiliximab, was scheduled to receive a living donor transplant and received basiliximab uneventfully (5). However, owing to donor infection the procedure was cancelled and rescheduled for 2 weeks later. Within 10 minutes after basiliximab reinduction she developed an anaphylactic reaction. In an attempt to find another induction therapy for this patient, skin testing was performed for daclizumab without response. She therefore received full-dose induction with daclizumab before her organ transplant without adverse effect. 

Dias VC, Tendler B, Oparil S, Reilly PA, Snarr P, White WB. Clinical e.xperience with transdermal clonidine in African-American and Hispanic-American patients tvith hypertension evaluation from a 12-week prospective, open-label clinical trial in community-based clinics. Am J Ther 1999 6(l) 19-24. 

Since diabetes mellitus is an insidious disorder, testing of asymptomatic patients may be desirable under certain conditions, including age 45 years or older obesity first-degree relatives of diabetics members of high-risk ethnic population (e.g.. Native American, Hispanic, African-American) women who have delivered an infant weighing more than 9 lb (4.08 kg) or have had gestational diabetes mellitus hypertension abnormal lipid studies recurring... 

Toxicity The principal adverse reactions to cyclosporine therapy are renal dysfunction, tremor, hirsutism, hypertension, hyperhpidemia, and gum hyperplasia. Hyperuricemia may lead to worsening of gout, increased P-glycoprotein activity, and hypercholesterolemia. Nephrotoxicity occurs in the majority of patients treated and is the major indication for cessation or modification of therapy. Hypertension occurs in -50% of renal transplant and almost all cardiac transplant patients. Combined use of calcineurin inhibitors and glucocorticoids is particularly diabetogenic, although this apparently is more problematic in patients treated with tacrohmus see below). Especially at risk are obese patients, African American or Hispanic recipients, or those with family history of type 2 diabetes or obesity. Cyclosporine, as opposed to tacrolimus, is more hkely to produce elevations in low-density lipoprotein (LDL) cholesterol. 

A young Hispanic female would not be considered high risk for hypertension and... 

Muntner et al. (2005) examined a U.S. cohort of men and women (total N, all studies = 9,961) in an NHANES data set covering 1999—2002. Quartiles of PbB comprised stratified Pb exposure and hypertension outcome measures. Significant increases in odds ratio for hypertension with increased PbB quartile was noted for Mexican-Americans and non-Hispanic Blacks. 

A 44-year-old Hispanic woman with pulmonary hypertension secondary to scleroderma, but no previous allergic disorders, had a generalized maculopapular rashafter taking bosentan for 18 days. Her symptoms subsided with oral betamethasone for 10 days and 1 month later she underwent skin tests, patch tests, lymphocyte transformation tests (all of which were also performed in three controls who had scleroderma and who had tolerated bosentan), and a controlled oral provocation test. The skin and patch tests were negative... 

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