The management of hypertensive disease in Black patients

The ethnic differences in the incidence, pathophysiology and management of hypertensive disease, are particularly pertinent to the Black or Afro-Caribbean populations, who have a high prevalence of hypertension and associated complications, such as strokes and renal impairment. Our understanding of...

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Bibliographic Details
Published in:QJM : An International Journal of Medicine 1999-04, Vol.92 (4), p.187-192
Main Authors: Gibbs, C.R., Beevers, D.G., Lip, G.Y.H.
Format: Article
Language:English
Subjects:
Adrenergic alpha-Antagonists - therapeutic use
Adrenergic beta-Antagonists - therapeutic use
African Continental Ancestry Group
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Arterial hypertension. Arterial hypotension
Benzothiadiazines
Biological and medical sciences
Blood and lymphatic vessels
Calcium Channel Blockers - therapeutic use
Cardiology. Vascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Diet, Sodium-Restricted
Diuretics
Humans
Hypertension - ethnology
Hypertension - physiopathology
Hypertension - therapy
Medical sciences
Sodium Chloride Symporter Inhibitors - therapeutic use
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Summary:The ethnic differences in the incidence, pathophysiology and management of hypertensive disease, are particularly pertinent to the Black or Afro-Caribbean populations, who have a high prevalence of hypertension and associated complications, such as strokes and renal impairment. Our understanding of the underlying pathophysiology of hypertensive disease and the optimal treatment of hypertension in Black patients continues to evolve, especially with the introduction of new drugs and the need for prognostic data in this ethnic population. We review the management of hypertensive disease in the black population, emphasizing race-related differences in the pathophysiology of hypertension and the importance of tailored management in this group of patients, including sensible application of non-pharmacological measures with effective antihypertensive agents. For example, diuretics and calcium antagonists are suitable first-line agents in black hypertensives, whilst beta-blockers and the ACE inhibitors tend to be less effective at lowering blood pressure, due to the low renin state in these patients.
ISSN:1460-2725
1460-2393
1460-2393
DOI:10.1093/qjmed/92.4.187