Death Toll From Uncontrolled Blood Pressure in Ethnic Populations: Universal Access and Quality Improvement May Not Be Enough

Cardiovascular disease (CVD) is the number 1 cause of death globally.1 An estimated 17.5 million people died from CVD in 2005 (7.6 million from coronary heart disease and 7.6 million from stroke), representing 30% of all global deaths.2 Globally, two-thirds of stroke and one-half of ischemic heart disease are attributable to nonoptimal blood pressure. Worldwide, nonoptimal blood pressure contributes to approximately 12.8% of all deaths (7.1 million) and 4.4% of all disability-adjusted life years (64.3 million) in the year 2000. These proportions are highest in more developed countries, such as the United States and the United Kingdom.3 Racial and ethnic disparities in cardiovascular disease prevalence, treatment, and outcomes are well documented in the United States, and racial and ethnic differences in hypertension are no exception.4-7 Cardiovascular disease accounts for 35% of excess overall mortality in US blacks, largely because of hypertension.8 In Europe, ethnic differences in hypertension prevalence and morbidity and mortality from cardiovascular disease have also been described