Document Detail


How to treat hypertension in blacks: review of the evidence.
MedLine Citation:
PMID:  20101869     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Presentation, response to therapy, and clinical outcome differ according to race for patients with hypertension. Black patients have a higher prevalence and earlier onset of hypertension than other ethnic groups, with poorer prognosis than white patients. Blacks are more likely to be salt-sensitive, and to have a low plasma renin activity than are whites. They are at much greater risk of developing cardiovascular and renal complications. Despite many advances in the understanding and treatment of cardiovascular diseases, black patients continue to have increased morbidity and mortality from the end-organ complications of hypertension. The explanations for these observations remain incompletely understood, but genetic differences, added to socio-economic and environmental factors, have been proposed to explain this disparity. The first therapeutic approach is to decrease salt and increase potassium intakes. Diuretics (thiazides and potassium-sparing agents) and calcium channel blockers constitute the first antihypertensive drug choices. The angiotensin-converting-enzyme inhibitors, the angiotensin II receptor blockers and beta-blockers appear to be less effective in blacks with regard to uncomplicated hypertension, especially in older people, but addition of a small dose of diuretic improves their efficacy. These combinations are preferred among patients with chronic kidney disease or heart failure. The goal for blood pressure target is the same in blacks as it is in whites, being a blood pressure of less than 140/90 mmHg in uncomplicated hypertension and less than 130/80 mmHg in patients with diabetes mellitus or chronic kidney disease.
Authors:
L D Kola; E K Sumaili; J M Krzesinski
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Acta clinica Belgica     Volume:  64     ISSN:  1784-3286     ISO Abbreviation:  Acta Clin Belg     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-03-04     Revised Date:  2014-03-18    
Medline Journal Info:
Nlm Unique ID:  0370306     Medline TA:  Acta Clin Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  466-76     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use
African Continental Ancestry Group*
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Antihypertensive Agents / therapeutic use*
Calcium Channel Blockers / therapeutic use
Diet, Sodium-Restricted*
Diuretics / therapeutic use
Humans
Hypertension / complications,  epidemiology,  ethnology*,  therapy*
Life Style*
Prevalence
Prognosis
Renin / blood
Risk Factors
Socioeconomic Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Diuretics; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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