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At baseline, mean (SD) high-density lipoprotein cholesterol levels were higher (tertile 3: 56.5 mg/dL vs tertile 1: 54.2 mg/dL P = .006), smoking prevalence (never smoking: tertile 3: 367 vs tertile 1: 372 P = .009) and mean (SD) Framingham Risk scores (tertile 3: 16.7 vs tertile 1: 18.1 P = .01) were lower, and baseline BP was not different across increasing tertiles of West African ancestry. Results Among 2466 participants in the current analysis (1122 women median West African ancestry, 81% ), there were 120 composite CV events (4.9%) over a mean (SD) of 3.2 (0.9) years of follow-up. Multivariable adjusted Cox models evaluated the association of West African ancestry with the risk of composite CV events (nonfatal myocardial infarction, CV death, and heart failure event). Main Outcomes and Measures Trajectories of BP and kidney function parameters on follow-up of the trial were assessed across tertiles of the proportion of West African ancestry using linear mixed-effect modeling after adjustment for potential confounders. Data were analyzed from May 2020 to September 2020. Recruitment started on October 20, 2010, and ended on August 20, 2015. Objective To determine the association between the proportion of West African ancestry with the response to antihypertensive medication, BP control, kidney function, and risk of adverse cardiovascular (CV) events among self-identified Black individuals in the Systolic Blood Pressure Intervention Trial (SPRINT).ĭesign, Setting, and Participants This post hoc analysis of the SPRINT trial incorporated data from a multicenter study of self-identified Black participants with available West African ancestry proportion, estimated using 106 biallelic autosomal ancestry informative genetic markers. The contribution of genetic West African ancestry to these racial disparities appears not to have been completely determined.

Importance Self-identified Black race is associated with higher hypertension prevalence and worse blood pressure (BP) control compared with other race/ethnic groups.