Furthermore, black patients were more likely to be aware they were hypertensive, more likely to be treated for hypertension, more likely to treated more intensively, but less likely to have their BP controlled. 2 Hypertension was also more severe in blacks; at baseline, ≈40% of blacks but only 25% of whites had systolic pressures >160 mm Hg. 2
Full Answer
What do blacks need to know about hypertension?
The “slavery hypertension hypothesis” states that the higher prevalence of hypertension among blacks could have resulted from an enhanced ability to conserve salt by slaves, protecting them from fatal salt-depletive diseases during the stormy Atlantic passage, such as diarrhea and vomiting. 5 This condition would induce hypertension when they and their descendants consumed the much higher sodium content in American compared with African foods.
Why do black Americans have higher prevalence of hypertension?
To date, researchers do not have a definitive answer to this question, but some believe that high blood pressure in African-Americans may be triggered by the following factors: Genetic factors. High rates of high blood pressure in African-Americans may be due to the genetic make-up of people of African descent.
How to treat hypertension in blacks?
Published in 2010, the book and executive summary consist of the following information:
- Burden data pertaining to African American men and high blood pressure.
- Effective and culturally appropriate promising practices and interventions.
- A list of men’s health informational resources.
How do African Americans treat hypertension?
calcium channel blockers and diuretics have been proposed as being particularly effective for african americans with hypertension.25-27angiotensin-converting enzyme (ace) inhibitors and angiotensin receptor blockers (arbs) have not been shown to be as effective in black populations compared with white populations.26-28similarly, ace inhibitors, …
Why are ACE inhibitors not first line for Black people?
Angiotensin converting enzyme (ACE) inhibitors, β blockers, and angiotensin receptor antagonists are generally less effective as monotherapy in black hypertensives,22,23 because of the tendency towards a low renin state and a lower cardiac output, with increased peripheral resistance.
Why hypertension is more common in Black people?
High rates of high blood pressure in Black people may be due to the genetic makeup of people of African descent. Researchers have uncovered some facts: In the U.S., Black people respond differently to high blood pressure drugs than do other groups of people.
How do African Americans treat hypertension?
Practice guidelines have long recommended that Black patients with high blood pressure and no comorbidities be treated initially with a thiazide diuretic or a calcium channel blocker (CCB) instead of an angiotensin converting enzyme inhibitor (ACEI) and/or angiotensin receptor blocker (ARB).
Why Is aggressive treatment of hypertension in African American patients so important?
Blacks are especially susceptible to hypertension(HTN) and its associated organ damage leading to adverse cardiovascular, cerebrovascular and renal outcomes. Accordingly, HTN is particularly significant in contributing to the black-white racial differences in health outcomes in the US.
How hypertension management is affected by ethnicity?
Hypertension awareness, treatment, and control were lowest among Mexican-Americans (68.7%, 58.7%, and 35.5%, respectively) compared with whites (aware: 79.1%, treated: 71.2%, and controlled: 48.6%) and blacks (aware: 80.8%, treated: 71.9%, and controlled: 43.0%).
Do African-Americans have higher blood pressure?
High blood pressure (hypertension) is a common problem in the United States. It's even more common in African Americans than among other ethnic groups. The rate of high blood pressure in African Americans is among the highest of any ethnic group in the U.S.
Why are ACE and arbs not recommended for African black population?
Angiotensin converting enzyme (ACE) inhibitors have been avoided as an initial therapeutic option in the treatment of hypertension in African-Americans. A major reason for this has been the widespread perception of clinicians that these agents have poor blood pressure (BP) lowering efficacy in this population.
Why do Afro Caribbean patients respond less well to ACE inhibitors?
Black people are labelled “low-renin responders” so are less likely to respond to ACE inhibitors.
Which antihypertensive is best for African American?
The American Society of Hypertension and the International Society of Hypertension recommends a CCB or thiazide diuretic (CCB preferred, but thiazide diuretic if cost is a concern) as initial drugs of choice for black patients. If additional treatment is indicated, they suggest adding an ACE-I or ARB.
Why are calcium channel blockers African American?
Calcium blockers are with diuretics among the most effective classes of drugs to reduce blood pressure in patients of African ancestry [3,7]. This drug type remains effective in all subgroups of sex, age and blood pressure strata, including high baseline diastolic blood pressure (>/= 110 mm Hg).
What is the first line antihypertensive for African American?
First-line pharmacologic treatment of hypertension for black patients includes thiazide diuretics or calcium channel blockers.
Which is the preferred drug for the treatment of hypertension in African American patients quizlet?
In this cohort, African Americans were most often treated with diuretics, CCBs, and ACE inhibitors. ACE inhibitors appear to be an effective adjunct to diuretic therapy in African Americans due to both the enhanced blood pressure lowering of that combination, and to the decreased production of angiotensin II.
What is the best therapy for low renin hypertensive?
However, there are 2 main groups of low-renin hypertensives: those with a primary aldosteronism phenotype (low renin/high aldosterone), for whom the best therapy is aldosterone antagonists and those with a Liddle phenotype (low renin/low aldosterone), for whom the specific therapy is amiloride.
What did Spence 44 suggest?
In 2006, Spence 44 suggested that physiologically individualized therapy based on phenotyping with plasma renin and aldosterone had the potential to eliminate or at least markedly diminish the racial disparities in hypertension and stroke in the United States.
How many black people have high blood pressure?
In the U.S., however, the difference is dramatic: 41% of blacks have high blood pressure, as compared to 27% of whites. In addition, black people in the U.S are more likely to be overweight than blacks in other countries.
How to make your blood pressure treatment plan work?
To be sure your high blood pressure treatment plan is working, follow these steps: Check your blood pressure as often as recommended by your doctor. Follow your treatment plan consistently. Let your doctor know right away if you have problems with part of the plan.
What is the bottom number of blood pressure?
The bottom number is called your diastolic blood pressure. This number represents the force of blood through your blood vessels in between heartbeats, while your heart is resting. 79 or below is normal diastolic blood pressure. 79 or below, combined with 120-129 systolic is elevated.
What is a stage 2 high blood pressure?
90 and greater is Stage 2 high blood pressure. Blood pressure changes throughout the day, depending on your activities. Blood pressure changes over time, as well. Systolic blood pressure tends to rise as you get older. Diastolic blood pressure may decrease as you get older.
What are the complications of high blood pressure?
African-Americans are more likely to develop complications associated with high blood pressure. These problems include stroke, kidney disease, blindness, dementia, ...
Can smoking cause high blood pressure?
Smoking. The more risk factors you have, the more likely it is that you have high blood pressure or will develop it in the future. Take steps now to find out more. Even if you don't have high blood pressure, you can lower your risk by following the treatment guidelines for high blood pressure in African-Americans.
Can you take more than one medication for high blood pressure?
Medication. Your doctor may prescribe medication to control your high blood pressure. It's common to take more than one drug to treat the problem. Your doctor may ask you to switch drugs or change the dosage until you find a combination that works best to control high blood pressure with the least side effects for you.
How many black people have hypertension?
In fact, one 2019 study found that 31% of Black adults aged 18–44 years had hypertension. It is important to note that some studies specifically look at Black Americans, who are part of a racial group subjected to racism and similar socioeconomic factors.
What happens if blood pressure is high?
If either number in the blood pressure reading is high, a person has hypertension. Hypertension increases the risk of heart disease and some other health concerns. Black people, especially Black men, live shorter lives. , on average, than people of most other racial groups — particularly white people.
What are the risk factors for hypertension?
These other risk factors for hypertension include: 1 smoking 2 having a family history of high blood pressure 3 having diabetes 4 having a high intake of alcohol 5 eating a high salt or high fat diet 6 having obesity 7 being older
What is the prevalence of high blood pressure?
, the overall prevalence of high blood pressure is 54% among non-Hispanic Black adults, compared with 46% in non-Hispanic white adults, 39% in non-Hispanic Asian adults, and 36% in Hispanic adults. Hypertension is a major risk factor for heart disease, stroke, ...
What is the difference between stage 1 and stage 2 blood pressure?
Having stage 2 high blood pressure means having a top number of 140 or higher over a bottom number of 90 or higher.
Is hypertension a risk factor for heart disease?
Hypertension is a major risk factor for heart disease, stroke, and other serious illnesses. , on average, a 45-year-old African American man who lives in the southeastern U.S. has the same risk of having a stroke as a 55-year-old white man living in the same region or a 65-year-old white man living in the Midwest.
Is high blood pressure treatable?
It is also treatable, especially with early diagnosis and intervention. People who think that they have high blood pressure or have several risk factors for it should contact a doctor to discuss diagnosis and treatment. Last medically reviewed on March 29, 2021. Hypertension.
What percentage of African Americans have high blood pressure?
The prevalence of high blood pressure (HBP or hypertension) in African-Americans in the United States is among the highest in the world. More than 40 percent of non-Hispanic African-American men and women have high blood pressure.
Does salt increase blood pressure?
Researchers have also found that there may be a gene that makes African-Americans much more salt sensitive. In people who have this gene, as little as one extra gram (half a teaspoon) of salt could raise blood pressure as much as 5 mm Hg. Learn more: Read about heart disease and stroke in African-Americans.
What are the factors that contribute to the racial and ethnic disparities of hypertension?
Interactions between genetic and social factors leading to body weight changes, differences in fat distribution (visceral versus subcutaneous), sodium and potassium balance/handling, and nocturnal diuresis may all contribute to the racial and ethnic disparities of hypertension.
What are the differences between blood pressure control rates and blood pressure prevalence?
Non-Hispanic blacks (NHB) have significantly higher rates of hypertension compared to non-Hispanic whites (NHW), while Hispanics and non-Hispanic Asians (NHA) have lower rates than both groups. 2 In an NHANES survey, 3 hypertension control rates among non-Hispanic white adults (55.7%) was significantly higher than NHB (48.5%), NHA (43.5%), and Hispanic (47.4%) adults.
What is the blood pressure threshold for stage 1 hypertension?
The 2017 ACC/AHA hypertension guidelines lowered the blood pressure threshold for diagnosis of stage I hypertension to 130-139/80-89 mm Hg. 1 This change resulted in a substantial increase in the prevalence of hypertension from ~32% to ~46% in the United States (US) adult population. 2 Although the new guidelines comprehensively address how to define, measure, and treat high blood pressure, management of hypertension in special patient groups has not been systematically addressed.
Why are blacks more likely to have cardiovascular disease?
Studies have consistently reported a higher prevalence of hypertension in blacks than in whites, a main reason for the higher incidence of cardiovascular disease in blacks. 1 The long list of putative causes for this higher prevalence suggests that the real reasons are still unknown. Biological differences in the mechanisms ...
What are the potential biases in NHANES?
Other potential biases, such as occupational-related physical activity, exposure to psychosocial stressors, discrimination, socioeconomic position in early life, social networks, and other unknown confounders, which may vary by ethnic background, were not investigated in the NHANES.
How does lifestyle change affect blood pressure?
Lifestyle modifications can result in improvements in blood pressure control. A 3.18 kg reduction in body weight can significantly reduce blood pressure. 15 An increase in potassium intake may also significantly reduce blood pressure in normokalaemic hypertensive patients. 16 This occurs, in part, because of a natriuretic effect of potassium.
What is the prevalence of hypertension in the Western world?
In a western adult population the prevalence of hypertension exceeds 20%. Hypertension is a major risk factor for cardiovascular and cerebrovascular disease. The pathophysiology of hypertension differs in black adults compared to South Asians and whites.
What are some examples of ACE inhibitors?
Examples include the use of β blockers after myocardial infarction and the use of ACE inhibitors in patients with systolic heart failure (that is, ejection fraction < 40%) or those with type 1 diabetes (formerly known as insulin dependent diabetes) with proteinuria. These compelling indications apply equally to black and white patients.
Is hypertension a major cause of death?
Hypertension is a major risk factor for cardiovascular and cerebrovascular disease, the major causes of death in the UK and other western countries. Recent studies indicate substantial ethnic differences in cardiovascular mortality. 7 For example, compared to whites, Afro-Caribbean and people of African descent have a higher incidence of stroke 8 and end stage renal failure, 9 whereas coronary artery disease is less common. Conversely, South Asians (defined as people originating from the Indian subcontinent and East Africa) have a higher incidence of coronary heart disease. 8
Is hypertension associated with mortality?
CONCLUSION. Hypertension is associated with significant morbidity and mortality, some of which can be reduced with effective blood pressure lowering. The prevalence of hypertension is greater in ethnic minority groups, compared to whites, within the UK.
Is ACE inhibitor effective in black hypertension?
Angiotensin converting enzyme (ACE) inhibitors, β blockers, and angiotensin receptor antagonists are generally less effective as monotherapy in black hypertensives, 22,23 because of the tendency towards a low renin state and a lower cardiac output, with increased peripheral resistance.
Does ACE blocker lower blood pressure?
The combination of diuretics and ACE inhibitors or β blockers produces equivalent lowering of blood pressure in whites and blacks, perhaps as a result of diuretic induced stimulation of renin release. This is true even for combination-type drugs that contain as little as 6.25–12.5 mg of hydrochlorothiazide.
Do African Americans have a higher risk of cardiovascular disease?
As a result, African-Americans also have a higher risk of blood pressure-related cardiovascular disease and renal (kidney) disease, according to the report.
Is hypertension more prevalent in African Americans?
The report noted hypertension is less well controlled in African-Americans compared to non-Hispanic whites (49.5 percent vs. 53.9 percent) despite higher awareness and higher usage of blood pressure-lowering medications. As a result, African-Americans also have a higher risk of blood pressure-related cardiovascular disease and renal (kidney) ...
