The Role of Multiple Drug Therapy for Controlling Hypertension in African Americans.
Hypertension among black Americans explains much of the black health disadvantage. Compared with white Americans, blacks develop hypertension at a younger age and have higher rates of stage 3 hypertension (i.e., blood pressure is greater than 180/110 mm Hg). Black Americans tend to wait longer for treatment after diagnosis, causing a longer duration of elevated blood pressure and greater target organ damage. To arrive at the recommended target blood pressure of less than 130/85 mm Hg (in patients with diabetes or renal failure) or 125/75 mm Hg (in patients with proteinuria greater than 1 g/24 hours), all antihypertensive drug classes can be considered. Tight blood pressure control in black Americans frequently requires the use of more than just one agent (monotherapy). Low dose combination therapy, such as a calcium channel blocker and an ACE inhibitor, can solve many of the clinical issues that must be considered when treating hypertension in this patient group. (c)2000 by Le Jacq Communications, Inc.
Weir
Matthew R.
MR
Division of Nephrology and Clinical Research Unit, University of Maryland School of Medicine, Baltimore, MD.