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Hypertension in African Americans

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Diabetes and Hypertension

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

Hypertension is a common clinical problem in African Americans and is associated with significant morbidity and mortality. Though there is a perception that hypertension can be difficult to control in this population, good understanding of the multitude of factors that can influence blood pressure can facilitate better management practices. In this chapter, we summarize the epidemiology and pathophysiology, and outline some strategies for systematic evaluation and management of hypertension in African Americans.

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References

  1. http://www.cdc.gov/bloodpressure/facts.htm. 2011.

  2. Carson AP, Howard G, Burke GL, Shea S, Levitan EB, Muntner P. Ethnic differences in hypertension incidence among middle-aged and older adults: the multi-ethnic study of atherosclerosis. Hypertension. 2011;57:1101–7.

    Article  PubMed  CAS  Google Scholar 

  3. Ford ES. Trends in mortality from all causes and cardiovascular disease among hypertensive and nonhypertensive adults in the United States. Circulation. 2011;123:1737–44.

    Article  PubMed  Google Scholar 

  4. Redmond N, Baer HJ, Hicks LS. Health behaviors and racial disparity in blood pressure control in the national health and nutrition examination survey. Hypertension. 2011;57:383–9.

    Article  PubMed  CAS  Google Scholar 

  5. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295:1549–55.

    Article  PubMed  CAS  Google Scholar 

  6. Flack JM, Sica DA, Bakris G, Brown AL, Ferdinand KC, Grimm Jr RH, et al. Management of high blood pressure in Blacks: an update of the International Society on Hypertension in Blacks consensus statement. Hypertension. 2010;56:780–800.

    Article  PubMed  CAS  Google Scholar 

  7. Peters RM, Flack JM. Salt sensitivity and hypertension in African Americans: implications for cardiovascular nurses. Prog Cardiovasc Nurs. 2000;15:138–44.

    Article  PubMed  CAS  Google Scholar 

  8. Calhoun DA. Hypertension in blacks: socioeconomic stress and sympathetic nervous system activity. Am J Med Sci. 1992;304:306–11.

    Article  PubMed  CAS  Google Scholar 

  9. Heffernan KS, Jae SY, Wilund KR, Woods JA, Fernhall B. Racial differences in central blood pressure and vascular function in young men. Am J Physiol Heart Circ Physiol. 2008;295:H2380–7.

    Article  PubMed  Google Scholar 

  10. Wang J, Chen W, Ruan L, Toprak A, Srinivasan SR, Berenson GS. Differential effect of elevated blood pressure on left ventricular geometry types in black and white young adults in a community (from the Bogalusa Heart Study). Am J Cardiol. 2011;107:717–22.

    Article  PubMed  Google Scholar 

  11. Okin PM, Kjeldsen SE, Dahlof B, Devereux RB. Racial differences in incident heart failure during antihypertensive therapy. Circ Cardiovasc Qual Outcomes. 2011;4:157–64.

    Article  PubMed  Google Scholar 

  12. Collins AJ, Foley RN, Herzog C, Chavers B, Gilbertson D, Ishani A, et al. US renal data system 2010 annual data report. Am J Kidney Dis. 2011;57:A8, e1-526.

    Article  Google Scholar 

  13. Genovese G, Friedman DJ, Ross MD, Lecordier L, Uzureau P, Freedman BI, et al. Association of trypanolytic ApoL1 variants with kidney disease in African Americans. Science. 2010;329:841–5.

    Article  PubMed  CAS  Google Scholar 

  14. Liebson PR. Cardiovascular disease in special populations III: stroke. Prev Cardiol. 2010;13:1–7.

    Article  PubMed  Google Scholar 

  15. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, et al. Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation. 2005;111:697–716.

    Article  PubMed  Google Scholar 

  16. Pickering TG, White WB. ASH position paper: home and ambulatory blood pressure monitoring. When and how to use self (home) and ambulatory blood pressure monitoring. J Clin Hypertens (Greenwich). 2008;10:850–5.

    Article  Google Scholar 

  17. Pogue V, Rahman M, Lipkowitz M, Toto R, Miller E, Faulkner M, et al. Disparate estimates of hypertension control from ambulatory and clinic blood pressure measurements in hypertensive kidney disease. Hypertension. 2009;53:20–7.

    Article  PubMed  CAS  Google Scholar 

  18. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560–72.

    Article  PubMed  CAS  Google Scholar 

  19. Cushman WC, Evans GW, Byington RP, Goff Jr DC, Grimm Jr RH, Cutler JA, et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. N Engl J Med. 2010;362: 1575–85.

    Article  PubMed  Google Scholar 

  20. Appel LJ, Wright Jr JT, Greene T, Agodoa LY, Astor BC, Bakris GL, et al. Intensive blood-pressure control in hypertensive chronic kidney disease. N Engl J Med. 2010;363:918–29.

    Article  PubMed  CAS  Google Scholar 

  21. Wright Jr JT, Agodoa LY, Appel L, Cushman WC, Taylor AL, Obegdegbe GG, et al. New recommendations for treating hypertension in black patients: evidence and/or consensus? Hypertension. 2010;56:801–3.

    Article  PubMed  CAS  Google Scholar 

  22. Cushman WC, Ford CE, Cutler JA, Margolis KL, Davis BR, Grimm RH, et al. Success and predictors of blood pressure control in diverse North American settings: the antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). J Clin Hypertens (Greenwich). 2002;4:393–404.

    Article  Google Scholar 

  23. Wright Jr JT, Agodoa L, Contreras G, Greene T, Douglas JG, Lash J, et al. Successful blood pressure control in the African American Study of kidney disease and hypertension. Arch Intern Med. 2002;162:1636–43.

    Article  PubMed  Google Scholar 

  24. Bosworth HB, Olsen MK, Grubber JM, Powers BJ, Oddone EZ. Racial differences in two self-management hypertension interventions. Am J Med. 2011;124:468.

    Article  PubMed  Google Scholar 

  25. Brennan T, Spettell C, Villagra V, Ofili E, McMahill-Walraven C, Lowy EJ, et al. Disease management to promote blood pressure control among African Americans. Popul Health Manag. 2010;13:65–72.

    Article  PubMed  Google Scholar 

  26. Houston TK, Allison JJ, Sussman M, Horn W, Holt CL, Trobaugh J, et al. Culturally appropriate storytelling to improve blood pressure: a randomized trial. Ann Intern Med. 2011;154: 77–84.

    PubMed  Google Scholar 

  27. Victor RG, Ravenell JE, Freeman A, Leonard D, Bhat DG, Shafiq M, et al. Effectiveness of a barber-based intervention for improving hypertension control in black men: the BARBER-1 study: a cluster randomized trial. Arch Intern Med. 2011;171:342–50.

    Article  PubMed  Google Scholar 

  28. Einhorn PT. National heart, lung, and blood institute-initiated program “interventions to improve hypertension control rates in African Americans”: background and implementation. Circ Cardiovasc Qual Outcomes. 2009;2:236–40.

    Article  PubMed  Google Scholar 

  29. Manze M, Rose AJ, Orner MB, Berlowitz DR, Kressin NR. Understanding racial disparities in treatment intensification for hypertension management. J Gen Intern Med. 2010;25:819–25.

    Article  PubMed  Google Scholar 

  30. Bell CN, Thorpe Jr RJ, Laveist TA. Race/Ethnicity and hypertension: the role of social support. Am J Hypertens. 2010;23:534–40.

    Article  PubMed  Google Scholar 

  31. Kressin NR, Orner MB, Manze M, Glickman ME, Berlowitz D. Understanding contributors to racial disparities in blood pressure control. Circ Cardiovasc Qual Outcomes. 2010;3:173–80.

    Article  PubMed  Google Scholar 

  32. Scisney-Matlock M, Bosworth HB, Giger JN, Strickland OL, Harrison RV, Coverson D, et al. Strategies for implementing and sustaining therapeutic lifestyle changes as part of hypertension management in African Americans. Postgrad Med. 2009;121:147–59.

    Article  PubMed  Google Scholar 

  33. Svetkey LP, Erlinger TP, Vollmer WM, Feldstein A, Cooper LS, Appel LJ, et al. Effect of lifestyle modifications on blood pressure by race, sex, hypertension status, and age. J Hum Hypertens. 2005;19:21–31.

    Article  PubMed  CAS  Google Scholar 

  34. Appel LJ, Giles TD, Black HR, Izzo Jr JL, Materson BJ, Oparil S, et al. ASH position paper: dietary approaches to lower blood pressure. J Am Soc Hypertens. 2010;4:79–89.

    Article  PubMed  CAS  Google Scholar 

  35. Materson BJ, Reda DJ, Cushman WC, Massie BM, Freis ED, Kochar MS, et al. Single-drug therapy for hypertension in men. A comparison of six antihypertensive agents with placebo. The department of veterans affairs cooperative study group on antihypertensive agents. N Engl J Med. 1993;328:914–21.

    Article  PubMed  CAS  Google Scholar 

  36. Wright Jr JT, Dunn JK, Cutler JA, Davis BR, Cushman WC, Ford CE, et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. 2005;293:1595–608.

    Article  PubMed  CAS  Google Scholar 

  37. Ernst ME, Carter BL, Goerdt CJ, Steffensmeier JJ, Phillips BB, Zimmerman MB, et al. Comparative antihypertensive effects of hydrochlorothiazide and chlorthalidone on ambulatory and office blood pressure. Hypertension. 2006;47:352–8.

    Article  PubMed  CAS  Google Scholar 

  38. Barzilay JI, Davis BR, Cutler JA, Pressel SL, Whelton PK, Basile J, et al. Fasting glucose levels and incident diabetes mellitus in older nondiabetic adults randomized to receive 3 different classes of antihypertensive treatment: a report from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Arch Intern Med. 2006;166:2191–201.

    Article  PubMed  CAS  Google Scholar 

  39. Sareli P, Radevski IV, Valtchanova ZP, Libhaber E, Candy GP, Den Hond E, et al. Efficacy of different drug classes used to initiate antihypertensive treatment in black subjects: results of a randomized trial in Johannesburg. S Afr Arch Intern Med. 2001;161:965–71.

    Article  CAS  Google Scholar 

  40. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288:2981–97.

    Article  Google Scholar 

  41. Wright Jr JT, Bakris G, Greene T, Agodoa LY, Appel LJ, Charleston J, et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002;288:2421–31.

    Article  PubMed  CAS  Google Scholar 

  42. Saunders E, Gavin JR. Blockade of the renin-angiotensin system in African Americans with hypertension and cardiovascular disease. J Clin Hypertens (Greenwich). 2003;5:12–7.

    Article  Google Scholar 

  43. Piller LB, Ford CE, Davis BR, Nwachuku C, Black HR, Oparil S, et al. Incidence and predictors of angioedema in elderly hypertensive patients at high risk for cardiovascular disease: a report from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). J Clin Hypertens (Greenwich). 2006;8:649–56.

    Article  Google Scholar 

  44. Lavie CJ, Messerli FH, Milani RV. Beta-blockers as first-line antihypertensive therapy the crumbling continues. J Am Coll Cardiol. 2009;54:1162–4.

    Article  PubMed  Google Scholar 

  45. Kamran H, Salciccioli L, Bastien C, Castro P, Sharma A, Lazar JM. Effect of beta blockers on central aortic pressure in African-Americans. J Am Soc Hypertens. 2011;5:94–101.

    Article  PubMed  Google Scholar 

  46. Taylor AL, Ziesche S, Yancy CW, Carson P, Ferdinand K, Taylor M, et al. Early and sustained benefit on event-free survival and heart failure hospitalization from fixed-dose combination of isosorbide dinitrate/hydralazine: consistency across subgroups in the African-American heart failure trial. Circulation. 2007;115:1747–53.

    Article  PubMed  CAS  Google Scholar 

  47. Calhoun DA, Jones D, Textor S, Goff DC, Murphy TP, Toto RD, et al. Resistant hypertension: diagnosis, evaluation, and treatment: a scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Circulation. 2008;117:e510–26.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Nephrology and Hypertension, Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH, USA

    Mahboob Rahman M.D., M.S.

Authors
  1. Mahboob Rahman M.D., M.S.
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Correspondence to Mahboob Rahman M.D., M.S. .

Editor information

Editors and Affiliations

  1. County Hospital, Division of Endocrinology,, SUNY-Downstate and Kings, 450 Clarkson Ave., Brooklyn, 11203, New York, USA

    Samy I. McFarlane

  2. ASH Comprehensive Hypertension Center, Department of Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC1027, Chicago, 60637, Illinois, USA

    George L. Bakris

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Rahman, M. (2012). Hypertension in African Americans. In: McFarlane, S., Bakris, G. (eds) Diabetes and Hypertension. Contemporary Diabetes. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-357-2_3

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  • DOI: https://doi.org/10.1007/978-1-60327-357-2_3

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60327-356-5

  • Online ISBN: 978-1-60327-357-2

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