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

  • Hypertension (MJ Sorrentino, Section Editor)
  • Published:
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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

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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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Authors and Affiliations

  1. Department of Medicine, Division of Translational Research and Clinical Epidemiology and Division of Endocrinology, Metabolism, and Hypertension, Wayne State University and the Detroit Medical Center, 4201 St. Antoine, 2E – UHC, Detroit, MI, 48201, USA

    John M. Flack

  2. Department of Medicine, Division of Cardiology, Wayne State University and the Detroit Medical Center, Detroit, MI, USA

    Tochukwi Okwuosa

  3. Department of Medicine, Division of General Medicine, Academic Hospitalist Section, Wayne State University and the Detroit Medical Center, Detroit, MI, USA

    Rajeev Sudhakar

  4. Department of Medicine, Division of Translational Research and Clinical Epidemiology and Cardiology, Wayne State University and the Detroit Medical Center, Detroit, MI, USA

    Brian Ference

  5. Department of Emergency Medicine, Wayne State University and the Detroit Medical Center, Detroit, MI, USA

    Phillip Levy

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  1. John M. Flack
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  2. Tochukwi Okwuosa
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  3. Rajeev Sudhakar
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  4. Brian Ference
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  5. Phillip Levy
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Correspondence to John M. Flack.

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Flack, J.M., Okwuosa, T., Sudhakar, R. et al. Should African Americans Have a Lower Blood Pressure Goal than Other Ethnic Groups to Prevent Organ Damage?. Curr Cardiol Rep 14, 660–666 (2012). https://doi.org/10.1007/s11886-012-0314-6

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  • DOI: https://doi.org/10.1007/s11886-012-0314-6

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