Does ethnicity impact outcomes in patients with hypertension?
29 Aug 2025
‘Global health’ means understanding differences related to ethnicity to ensure patients receive the most appropriate treatments. Head to the Research Gateway this afternoon where Doctor Marco Bernardi (Sapienza University of Rome - Rome, Italy) will present the results of a meta-regression analysis comparing the incidence of major cardiovascular (CV) events across different ethnic groups from randomised controlled trials (RCTs) evaluating antihypertensive treatments.
The meta-regression analysis included data from 142,871 patients – 82,472 Caucasian, 16,221 African-American and 44,178 Asian – participating in 24 RCTs published between 1997 and 2024. Eligible trials were published in peer-reviewed journals and included adult hypertensive populations that were homogenous by race. The incidences of CV outcomes (acute myocardial infarction [MI], CV death, heart failure and stroke) were adjusted for baseline systolic blood pressure, age, sex, 10 mmHg systolic pressure reduction and high CV risk.
CV outcomes were found to differ significantly across ethnicities, with a higher CV burden in African-Americans. Overall, the incidence of CV outcomes was around 40 events per 1,000 patient-years in African-American patients and approximately 26 events per 1,000 patient-years in Caucasian and in Asian patients. Compared with Caucasians, African-American patients had a significantly higher incidence of MI (odds ratio [OR] 1.003; 95% CI 1.001 to 1.005; p=0.011), heart failure (OR 1.006; 95% CI 1.003 to 1.008; p<0.001), stroke (OR 1.004; 95% CI 1.000 to 1.007; p=0.037) and CV death (OR 1.006; 95% CI 1.003 to 1.010; p=0.001). While Asian patients had a higher incidence of stroke than Caucasians (OR 1.004; 95% CI 1.002 to 1.007; p=0.002), they had a lower incidence of MI (OR 0.998; 95% CI 0.996 to 0.999; p=0.002).
The authors conclude that ethnic differences should be considered when selecting the most appropriate treatments to manage CV risk in patients with hypertension.
