Hypertension in minorities - blacks.

Hypertension is known to occur much more frequently in African Americans than in the general population, with an occurrence of 33 to 50% higher. In addition, severe hypertension occurs 3-7 times more common in blacks than whites and is associated with an excessive amount of target organ damage. Thus, damage to the heart, kidneys and cerebral structures may occur as much as 3-5 times more frequent in the African American than the general population and is associated with a much greater mortality. Because of the differences and clinical presentation, often delay in entering the medical care system, and some pathophysiological features specific for the African-American population, treatment becomes somewhat more challenging and should be tailored for this population. Because economic factors often found in minority populations, inexpensive effective drugs such as diuretics and beta-blockers, which are preferred drugs according to the JNC #5, often should be given first consideration in this population. However, calcium channel blockers seem to be quite effective in this group, equal to the white population, although they are somewhat more expensive. ACE inhibitors, if given in proper dosing and especially with low dose diuretics, are also quite effective in this population. Tissue specific ACE inhibitors may be more effective but further studies are needed. Studies have shown that with effective treatment of the African-American population in spite of the differences and the more challenging situations, can result in improved survival and reduction in the morbidity and mortality from the various complications.