Hypertension in blacks is usually characterized by low renin, expanded volume and sensitivity to salt. Diuretics are the preferred initial therapy, but response to calcium channel antagonists is also good.
Full Answer
How is hypertension (high blood pressure) treated in African Americans?
Thiazide diuretics remain the drugs of first choice for treating hypertension in the African-American hypertensive. The calcium channel blockers (CCBs) are attractive alternatives to thiazides in patients uncontrolled by or intolerant of thiazides or who have specific indications for these agents (eg, angina, severe diastolic dysfunction).
Which drugs are best for black patients with hypertension?
African Americans respond better to combination ACE inhibitor plus diuretic Mandi Sehgal, MD University of Cincinnati. Treat African American patients with hypertension according to the Joint National Committee on Prevention, Detection, and Treatment of …
What are the treatment options for Stage 2 hypertension (high blood pressure)?
Apr 01, 2013 · However, a recent study of African‐American clients of a NYC home health care agency found that among their treated, but uncontrolled, hypertensives, only 48% were taking diuretics, despite finding that diuretics were associated with better BP control in that population. 27 This NYC study sampled African Americans of relatively low socioeconomic status (43% …
What is the best diuretic for black patients?
In the text of the guideline, mentions that diuretics should be the agent of first choice for blacks with hypertension because of their proven effectiveness in clinical trials. For whites, beta-blockers are also an option for first line therapy. Mono-therapy with beta-blockers or ACE-Is is less effective in blacks.
Why is the Jackson Heart Study important?
In conclusion, this report from the Jackson Heart Study is important because it links suppressed renin to the pathogenesis of hypertension in Black patients , with a higher prevalence of a Liddle phenotype than previously recognized.
Is amiloride better than spironolactone?
Amiloride is more effective than spironolactone in patients with the Liddle phenotype. 15 It is therefore a mistake to simply add an aldosterone antagonist in resistant hypertension as outlined in the guidelines. In the Jackson Heart Study, 15.9% had the Liddle phenotype and 9.3% had the PA phenotype.