Incidence and correlates of hypertension in the Atherosclerosis Risk in Communities (ARIC) study and the Monitoring Trends and Determinants of Cardiovascular Disease (POL-MONICA) project

Objective The purpose of this research is to assess short-term blood pressu re change and hypertension incidence, and identify correlates of incident h ypertension in the USA and Poland. Design and methods Population-based samples aged 45-64 years at enrollment from the Atherosclerosis Risk in Communities (ARIC) and the Pol-MONICA stud ies: including 3777 whites from Minneapolis, Minnesota, USA suburbs (urban) , 3635 whites from Washington County, Maryland, USA (semi-rural) and 3109 b lacks from Jackson, Mississippi, USA surveyed in 1987-1989 and 1990-1992; a nd 389 persons from Warsaw, Poland (urban) and 322 from Tarnobrzeg Province , Poland (semi-rural) surveyed in 1987-1988 and 1992-1993. Results Age-standardized systolic and diastolic blood pressures at both scr eens were 9-20 and 5-9 mmHg higher in the Polish samples than in US blacks, who had higher levels than US whites. Age-adjusted annual hypertension inc idence in both Polish male cohorts (6-8%) was higher than that in US white men (4%) and approaching that of US black men (7%); rates were also higher in Polish female cohorts (8-9%) than in US black women (8%), but nearly twi ce those in US white women (4%). Factors independently related to hypertens ion incidence included age, family history, smoking, baseline blood pressur es and body mass index, and increase in body mass index and alcohol consump tion between screenings. After adjustment for these factors, annualized hyp ertension incidence was similar in US white and Polish men (2.3 and 2.7%) c ompared with US black men (3.4%), and in US white and Polish women (1.5 and 1.3%) compared with US black women (3.9%). Conclusions Despite substantial differences in blood pressure levels and ag e-standardized hypertension incidence rates, the differences in incidence b etween Polish and US white men appear to be explained largely by difference s in risk factors for hypertension. J Hypertens 2000, 18:999-1006 (C) Lippi ncott Williams & Wilkins.