Combination antihypertensive therapy is usually required to adequately control hypertension in Black patients
- PDF / 111,670 Bytes
- 4 Pages / 612.28 x 790.87 pts Page_size
- 7 Downloads / 187 Views
Combination antihypertensive therapy is usually required to adequately control hypertension in Black patients Black individuals are at high risk of developing hypertension and resistance to antihypertensive treatment. In addition to lifestyle changes, most patients will require treatment with a combination of antihypertensive agents to achieve their blood pressure goal.
Western Black population has a high risk of hypertension ... There is a high prevalence of hypertension in individuals of African descent in Western countries, such as the US[1] and UK,[2] which is not seen in those in other regions, such as West Africa.[3] Although adequate control of blood pressure (BP) remains a global problem,[4] the rates of BP control are the lowest in the Black population,[5] even among those receiving treatment.[6] For example, in the US, BP control rates are 29.9% for Black men overall,[5] and 45% for Black patients receiving antihypertensive treatment.[6] Because hypertension is a main contributor to morbidity (ยป30% of all deaths in Black males and 20% in Black females in the US),[7] the management of hypertension in the Black population is a major clinical and public health concern.[4,8] This article summarizes the treatment of hypertension in this patient population, as reviewed by Flack et al.[8] and recommended by the International Society on Hypertension in Blacks (ISHIB).[4]
y as multiple risk factors are present Although there are no risk factors for hypertension unique to any ethnic group, some pathophysiological mechanisms occur more frequently in certain ethnicities.[4,8] The factors most commonly seen in the Black population are presented in table I. In addition, there is a high prevalence of hypertensionassociated co-morbidities, such as diabetes mellitus and chronic kidney disease in the Black population.[4,8] The presence of these risk factors is thought to contribute to the early onset of hypertension, pressure-related end-organ injury and resistance to antihypertensive treatment commonly seen in Black individuals.[8] Non-physiological risk factors (e.g. illiteracy) may also play a role.[4]
Advise lifestyle modifications Optimal management of hypertension requires a combination of lifestyle modifications and drug therapy.[8] The ISHIB recommends that lifestyle modifications be instigated in all Black individuals diagnosed with hypertension, regardless of antihypertensive therapy requirements.[4] In addition, the ISHIB endorses lifestyle modifications in Black individuals with BP >115/75 mmHg, as every 20/10 mmHg increase above this threshold doubles the risk of cardiovascular disease.[4] Because of the high prevalence of obesity and salt sensitivity in Black patients with hypertension, reducing dietary
Table I. Inter-related risk factors thought to contribute to elevated blood pressure (BP) in Black individuals[4,8] Obesity Highly prevalent, particularly in females, with an early onset Generally attributed to less physical activity and consumption of more calories in Black than White individuals Risk fac
Data Loading...
