Management of High Blood Pressure in Blacks
Top Cited Papers
Open Access
- 1 November 2010
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Hypertension
- Vol. 56 (5), 780-800
- https://doi.org/10.1161/hypertensionaha.110.152892
Abstract
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 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.Keywords
This publication has 100 references indexed in Scilit:
- Cancer Survivorship Care: Exploring the Role of the General InternistJournal of General Internal Medicine, 2009
- Characterization of Resistant HypertensionAssociation Between Resistant Hypertension, Aldosterone, and Persistent Intravascular Volume ExpansionArchives of Internal Medicine, 2008
- Racial Differences in Blood Pressure Control: Potential Explanatory FactorsJournal of General Internal Medicine, 2008
- Clinical Outcomes by Race in Hypertensive Patients With and Without the Metabolic SyndromeAntihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)Archives of Internal Medicine, 2008
- Human adipocytes induce an ERK1/2 MAP kinases-mediated upregulation of steroidogenic acute regulatory protein (StAR) and an angiotensin II — sensitization in human adrenocortical cellsInternational Journal of Obesity, 2007
- Social problem solving training for African Americans: Effects on dietary problem solving skill and DASH diet-related behavior changePatient Education and Counseling, 2007
- Perceived Discrimination and Adherence to Medical Care in a Racially Integrated CommunityJournal of General Internal Medicine, 2007
- Prevalence of Overweight and Obesity in the United States, 1999-2004JAMA, 2006
- Trends in Blood Pressure Among Children and AdolescentsJAMA, 2004
- The Effect of Weight Loss on the Sensitivity of Blood Pressure to Sodium in Obese AdolescentsThe New England Journal of Medicine, 1989