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Hypertension in the US Black Population: Risk Factors, Complications, and Potential Impact of Central Aortic Pressure on Effective Treatment

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Abstract

Purpose

The identification of specific factors that contribute to hypertension development and progression among blacks in the US is the focus of much ongoing research. The purpose of this paper is to review these factors and discuss how they present unique opportunities for improving the management of hypertension in this difficult-to-treat population.

Methods

We searched the published literature for articles discussing the risk factors for hypertension and cardiovascular disease in blacks; the target-organ damage and cardiovascular complications associated with hypertension in this difficult-to-treat population; and the role of central blood pressure in predicting cardiovascular events.

Results

The prevalence of hypertension is higher in blacks than in other race/ethnic groups, with environmental and genetic risk factors likely playing an important role. The cardiovascular and renal consequences of hypertension (eg, left ventricular hypertrophy and renal failure) are also greater in blacks relative to their white counterparts. Preliminary data suggest that central blood pressure may be higher in blacks than in whites and has the potential for greater prognostic capability relative to peripheral blood pressure.

Conclusions

There is an urgent need to successfully control hypertension in the black population. Although data are limited in blacks, evidence suggests that central blood pressure warrants more continued assessment in future clinical studies.

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Acknowledgements

Technical assistance with editing, figure preparation and styling of the manuscript for submission was provided by Oxford PharmaGenesis Inc. and was funded by Novartis Pharmaceuticals Corporation. The first draft of the manuscript was provided by the authors. The authors were fully responsible for all content and editorial decisions and received no financial support or other form of compensation related to the development of this manuscript. The opinions expressed in the manuscript are those of the authors and Novartis Pharmaceuticals had no influence on the contents.

Conflict of Interest

Dr. Ferdinand has received research support and honoraria from AstraZeneca Pharmaceuticals LP; Merck & Co., Inc.; Novartis Pharmaceuticals Corporation; Pfizer Inc; Forest Labs; and Daiichi Sankyo. Dr. Townsend has received research support from the National Institutes of Health and Novartis. Dr. Townsend has received honoraria from the American Society of Nephrology and the American Society of Hypertension and has a consultant/advisory board relationship with GlaxoSmithKline and Roche.

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  1. Division of Cardiology, Tulane University School of Medicine and Association of Black Cardiologists, Inc., 1430 Tulane Ave, SL-48, New Orleans, LA, 70112, USA

    Keith C. Ferdinand

  2. University of Pennsylvania, Philadelphia, PA, USA

    Raymond R. Townsend

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  1. Keith C. Ferdinand
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Correspondence to Keith C. Ferdinand.

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Ferdinand, K.C., Townsend, R.R. Hypertension in the US Black Population: Risk Factors, Complications, and Potential Impact of Central Aortic Pressure on Effective Treatment. Cardiovasc Drugs Ther 26, 157–165 (2012). https://doi.org/10.1007/s10557-011-6367-8

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