Current Cardiology Reports

, Volume 14, Issue 6, pp 660–666 | Cite as

Should African Americans Have a Lower Blood Pressure Goal than Other Ethnic Groups to Prevent Organ Damage?

  • John M. Flack
  • Tochukwi Okwuosa
  • Rajeev Sudhakar
  • Brian Ference
  • Phillip Levy
Hypertension (MJ Sorrentino, Section Editor)

Abstract

African Americans manifest an inordinately high burden of hypertension, pressure-related target-organ injury (eg, left ventricular hypertrophy, stroke), and sub-optimal hypertension control rates to conventional levels (<140/90 mm Hg). A substantive proportion of the excessive premature mortality in African Americans relative to Whites is pressure-related. Randomized prospective pharmacologic hypertension end-point trials have shown invariable cardiovascular disease (CVD) risk reduction across a broad range of pre-treatment BP levels down to 110/70 mm Hg with the magnitude of CVD risk reduction across the 5 major antihypertensive drug classes being directly linked to degree of blood pressure (BP) lowering. Pooled endpoint data from pharmacologic hypertension trials in African Americans showed that CVD risk reduction was the same with major antihypertensive drug classes when similar levels of BP were achieved. A lower than conventional BP target for African Americans seems justified and prudent because attainment of lower BP should incrementally lower CVD risk in this high-risk population

Keywords

Hypertension Hypertension control rates Target-organ injury Target blood pressure Cardiovascular disease African Americans 

Notes

Disclosure

Conflicts of interest: J.M. Flack has received grant support from the NIH, Novartis, Medtronic and Daiichi Sankyo. He serves as a consultant to Medtronic, Back Beat Hypertension, NIH and Novartis; T. Okwuosa, R. Krishamoorthi, B. Ference: none; P. Levy has received grant support from The Robert Wood Johnson Foundation Physician Faculty Scholars Program-Grant #64319.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • John M. Flack
    • 1
  • Tochukwi Okwuosa
    • 2
  • Rajeev Sudhakar
    • 3
  • Brian Ference
    • 4
  • Phillip Levy
    • 5
  1. 1.Department of Medicine, Division of Translational Research and Clinical Epidemiology and Division of Endocrinology, Metabolism, and HypertensionWayne State University and the Detroit Medical CenterDetroitUSA
  2. 2.Department of Medicine, Division of CardiologyWayne State University and the Detroit Medical CenterDetroitUSA
  3. 3.Department of Medicine, Division of General Medicine, Academic Hospitalist SectionWayne State University and the Detroit Medical CenterDetroitUSA
  4. 4.Department of Medicine, Division of Translational Research and Clinical Epidemiology and CardiologyWayne State University and the Detroit Medical CenterDetroitUSA
  5. 5.Department of Emergency MedicineWayne State University and the Detroit Medical CenterDetroitUSA

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