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Clinical Guidelines for the Treatment of Hypertension in African Americans

  • Therapy in Practice
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Abstract

African Americans represent a population with the highest prevalence of hypertension in the world, associated with earlier onset, more severity, poorer control rates, and more cardiovascular and renal complications than White Americans. The high prevalence of type 2 diabetes mellitus in African Americans, compared with Whites, compounds the excessive burden of cardiovascular and kidney disease. The Hypertension in African American Working Group of the International Society of Hypertension in Blacks recently developed a consensus document that presented a practical, evidence-based approach aimed at achieving better blood pressure control. It was thought that a new approach, targeted at US Blacks, was needed to achieve better blood pressure control and enhanced target tissue protection. Key elements of the document include (i) emphasis on the importance of therapeutic lifestyle modification such as weight loss, decreased sodium ingestion, increased potassium intake, exercise, and weight loss, to name a few; (ii) recommendation of combination antihypertensive agents because of the high prevalence of individuals with >15mm Hg above SBP goal and/or 10mm Hg above DBP goal (140/90 unless there is also diabetes and/or kidney disease with >lg proteinuria daily). Effective combinations include β-adrenoceptor antagonist/diuretic, ACE inhibitor/diuretic, ACE inhibitor/calcium channel antagonist, and angiotensin receptor antagonist/diuretic; and (iii) the recommendations do not differ from other racial/ethnic groups where specific or compelling indications for the use of specific classes of antihypertensive agents exist.

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Acknowledgments

No sources of funding were used to assist in the preparation of this study. The author has received honoraria from Novartis, Pfizer, Wyeth-Ayerst, Merck, Sankyo, Forest, Abbott, Biovail, and GlaxoSmith Kline.

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Authors and Affiliations

  1. Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA

    Janice G. Douglas

  2. University Hospitals of Cleveland, Cleveland, Ohio, USA

    Janice G. Douglas

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  1. Janice G. Douglas
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Correspondence to Janice G. Douglas.

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Douglas, J.G. Clinical Guidelines for the Treatment of Hypertension in African Americans. Am J Cardiovasc Drugs 5, 1–6 (2005). https://doi.org/10.2165/00129784-200505010-00001

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