At the time of the original application it was not clear that adequate procedures were available to allow standardization of mean BP across sites, especially since differences between some sites might be as little as 2 mmHg. In-depth studies are being carried out at one of the African sites to investigate the earliest stages of hypertension risk for a population. Prospective study of blood pressure and mortality. It is well known that hypertension accounts for much of the excess mortality among US blacks. It is less well recognized, however, that death rates among blacks in the US are higher than reported in the Caribbean or Africa.
Hypertension is likely to account for that differential.
A follow-up study in each region is proposed to estimate the relative and attributable risk from hypertension. The populations in this study share a common ancestral origin in West Africa. In addition, pilot studies on genetic distance and candidate genes for hypertension will be conducted. The increased risk of hypertension in US blacks remains a major unsolved public health problem. Comparisons between macro-population groups in the US suffer from confounding by social factors and genetic admixture.