Higher risks of blood pressure (BP) progression and incident hypertension were found in relation to higher plasma endothelin (ET)-1 levels in a large, community-based sample of African Americans.

• Data from 1197 Jackson Heart Study participants without hypertension (mean age 47.8 years [SD: 12.0]; 64.2% women), with plasma ET-1 available at the baseline examination (2000-2004), were analyzed.

• A median follow-up of 7 years (range: 4-11) revealed progression to a higher BP stage in 71.2% (n = 854) and development of hypertension in 64.6% (n = 773) of the participants.

• Post-adjusting for likely confounders, each unit increase in baseline log (ET-1) was found to be linked with higher risks of BP progression (risk ratio: RR 1.15) and incident hypertension (RR 1.15).

• Significantly higher risks of BP progression (RR 1.20) and incident hypertension (RR 1.16) were present in participants in the highest ET-1 quartile, vs those in the lowest quartile.