Higher prevalence of hypertension among afro-descendants compared to other ethnic groups has been reported in high-income countries. Genetic, behavioral, and socioeconomic factors could explain these differences, and body composition could contribute. This study aims to assess the association between handgrip strength (HGS) and hypertension in different ethnicities in a middle-income country. We additionally evaluated the role of socioeconomic and behavioral factors to explain ethnic differences.
Design and method:
We evaluated the association between HGS measured by Jamar Dynamometer and the risk hypertension in 4102 adults aged 35 to 70 years from 3 ethnic groups (593 whites, 3001 mestizos, 508 afro-descendants) enrolled in the prospective population-based cohort study PURE-Colombia. We calculated unadjusted and adjusted odds ratios (95% CI) for the prevalence of hypertension across tertiles of HGS and the association with anthropometric, socioeconomic, and behavioral factors.
Results: The overall prevalence of hypertension was 39.2%, being greater in the afro-descendants (46.3%) than in whites (41.5%) and mestizos (37.6%). A higher prevalence of hypertension was found in mestizos and afro-descendants in tertile 1 of HGS (< 21 kg) compared to those in tertile 3 of HGS (> 29.7 kg) (OR = 1.48; 95% CI: 1.20 - 1.84 and OR = 1.70; 95% IC: 1.01 – 2.85, respectively). However, when adjusting by confounders, the association lost statistical significance. The prevalence of hypertension was positively associated with body mass index and waist circumference. There was a higher prevalence amongst individuals with a low educational level compared to those with a high educational level in whites (OR = 1.74; 95% CI: 1.08 - 2.78), mestizos (OR = 1.5 95% CI: 1.13 - 2.01), and afro-descendants (OR = 2.46; 95% CI: 1.11 - 5.45). Behavioral factors, such as alcohol and tobacco intake, protein, and fat consumption, were not associated with a higher prevalence of hypertension.
HGS could partially contribute to explaining ethnic differences in the prevalence of hypertension. However, socioeconomic factors such as education level play a key role. Therefore, a greater focus on screening for low HGS, interventions aimed at attenuating age-related declines, and addressing social inequalities could positively impact these differences.