Reference : How to treat hypertension in blacks: review of the evidence
Scientific journals : Article
Human health sciences : Urology & nephrology
http://hdl.handle.net/2268/40377
How to treat hypertension in blacks: review of the evidence
English
Kola, Luc mailto [Centre Hospitalier du Bois de l'Abbaye (CHBA), seraing, Belgique > > Néphrologie-Dialyse > >]
Sumaili, Ernest mailto [Centre Hospitalier Universitaire de Liège - CHU > Médecine Interne > Néphrologie-Transplantation > >]
Krzesinski, Jean-Marie mailto [Université de Liège - ULg > Département des sciences cliniques > Néphrologie >]
2009
Acta Clinica Belgica
Acta Clinica Belgica
64
6
466-476
Yes (verified by ORBi)
National
0001-5512
Bruxelles
Belgique
[en] African-Americans ; Antihypertensive treatment ; Arterial hypertension ; Hypertensive blacks ; Hypertensive complications ; Sub-Saharan Africans
[en] Abstract : Presentation, response to therapy, and clinical outcome differ according to race for patients with hypertension. Black patients have a higher prevalence and earlier onset of hypertension than other ethnic groups, with poorer prognosis than white patients. Blacks are more likely to be salt-sensitive, and to have a low plasma renin activity than are whites. They are at much greater risk of developing cardiovascular and renal complications. Despite many advances in the understanding and treatment of cardiovascular diseases, black patients continue to have increased morbidity and mortality from the end-organ complications of hypertension. The explanations for these observations remain incompletely understood, but genetic differences, added to socio-economic and environmental factors, have been proposed to explain this disparity. The first therapeutic approach is to decrease salt and increase potassium intakes. Diuretics (thiazides and potassium-sparing agents) and calcium channel blockers constitute the first antihypertensive drug choices. The angiotensin-converting-enzyme inhibitors, the angiotensin II receptor blockers and beta-blockers appear to be less effective in blacks with regard to uncomplicated hypertension, especially in older people, but addition of a small dose of diuretic improves their efficacy. These combinations are preferred among patients whith chronic kidney disease or heart failure. The goal for blood pressure target is the same in blacks as it is in whites, being a blood pressure of less than 140/90 mmHg in uncomplicated hypertension and less than 130/80 mmHg in patients with diabetes mellitus or chronic kidney disease.
Researchers ; Professionals
http://hdl.handle.net/2268/40377
http://www.actaclinicabelgica.be

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