Therapeutic considerations in the African-American patient with hypertension: considerations with calcium channel blocker therapy.
African Americans have a higher prevalence, earlier onset, and more rapid progression of hypertensive end-organ disease, as well as excessive hypertensive mortality compared with other racial/ethnic groups. Most differences in hypertension and pressure-related complications between African Americans and whites appear to be quantitative and not qualitative. Improving the diagnosis, treatment, and control of hypertension in this highly vulnerable population is a major health care goal for the new millennium. In this regard the dietary pattern to be promoted for reduction of hypertension risk in African Americans is one of increased consumption of dairy products, fruit, and vegetables as well as a continued emphasis on decreased Na+ intake. When pharmacologic therapy is considered, multi-drug approaches are generally required, with diuretics, angiotensin-converting enzyme inhibitors (or angiotensin receptor blockers), and calcium channel blocker therapy as oft-selected components of most such treatment regimens.
Flack
John M
JM
Wayne State University, University Health Center 2E, 4201 St. Antoine, Detroit, MI 48201, USA. jflack@intmed.wayne.edu
Sica
Domenic A
DA
D000328:Adult; D001741:Black or African American / Q000235:genetics* / Q000706:statistics & numerical data; D017677:Age Distribution; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology* / Q000235:genetics; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D020521:Stroke / Q000208:ethnology / Q000517:prevention & control; D015996:Survival Rate; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers