Document Detail


Management of high blood pressure in Blacks: an update of the International Society on Hypertension in Blacks consensus statement.
MedLine Citation:
PMID:  20921433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Since the first International Society on Hypertension in Blacks consensus statement on the "Management of High Blood Pressure in African American" in 2003, data from additional clinical trials have become available. We reviewed hypertension and cardiovascular disease prevention and treatment guidelines, pharmacological hypertension clinical end point trials, and blood pressure-lowering trials in blacks. Selected trials without significant black representation were considered. In this update, blacks with hypertension are divided into 2 risk strata, primary prevention, where elevated blood pressure without target organ damage, preclinical cardiovascular disease, or overt cardiovascular disease for whom blood pressure consistently <135/85 mm Hg is recommended, and secondary prevention, where elevated blood pressure with target organ damage, preclinical cardiovascular disease, and/or a history of cardiovascular disease, for whom blood pressure consistently <130/80 mm Hg is recommended. If blood pressure is ≤10 mm Hg above target levels, monotherapy with a diuretic or calcium channel blocker is preferred. When blood pressure is >15/10 mm Hg above target, 2-drug therapy is recommended, with either a calcium channel blocker plus a renin-angiotensin system blocker or, alternatively, in edematous and/or volume-overload states, with a thiazide diuretic plus a renin-angiotensin system blocker. Effective multidrug therapeutic combinations through 4 drugs are described. Comprehensive lifestyle modifications should be initiated in blacks when blood pressure is ≥115/75 mm Hg. The updated International Society on Hypertension in Blacks consensus statement on hypertension management in blacks lowers the minimum target blood pressure level for the lowest-risk blacks, emphasizes effective multidrug regimens, and de-emphasizes monotherapy.
Authors:
John M Flack; Domenic A Sica; George Bakris; Angela L Brown; Keith C Ferdinand; Richard H Grimm; W Dallas Hall; Wendell E Jones; David S Kountz; Janice P Lea; Samar Nasser; Shawna D Nesbitt; Elijah Saunders; Margaret Scisney-Matlock; Kenneth A Jamerson;
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Publication Detail:
Type:  Consensus Development Conference; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-10-04
Journal Detail:
Title:  Hypertension     Volume:  56     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-21     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  780-800     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Wayne State University, Detroit, Mich, USA. jflack@med.wayne.edu
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group*
Antihypertensive Agents / therapeutic use
Humans
Hypertension / ethnology*,  prevention & control,  therapy*
Grant Support
ID/Acronym/Agency:
5 U01 DK 48400/DK/NIDDK NIH HHS; U01 HL79151/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents
Comments/Corrections
Comment In:
Hypertension. 2010 Nov;56(5):801-3   [PMID:  20921426 ]

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


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