Differences in hypertension between blacks and whites: an overview.
Hypertension is more prevalent and severe in urban black populations compared to whites, and is associated with a greater degree of target-organ damage for any given blood pressure level. In general, compared to whites, blacks respond well to diuretics and calcium channel blockers and less well to beta-blockers and ACE inhibitors. The exact mechanisms that contribute to differences in blood pressure between blacks and whites are still not fully understood, given the multi-factorial aetiology of essential hypertension. Various lines of evidence suggest black patients are more salt sensitive than whites, which is due to a tendency to retain sodium in the kidney. Inherent differences in ionic transport mechanisms, the renal epithelial sodium channel, the reninangiotensin-aldosterone system and vasoactive substances may be a partial explanation, but analysis is compounded by disparate socio-economic conditions between blacks and whites. At present, there is no complete explanation for these differences and further research is required.
Lindhorst
Jane
J
Division of Hypertension, Department of Medicine, Groote Schuur Hospital and University of Cape Town.
Alexander
Nichole
N
Blignaut
Juliet
J
Rayner
Brian
B
D000959:Antihypertensive Agents / Q000627:therapeutic use; D044383:Black People; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000208:ethnology* / Q000209:etiology; D017136:Ion Transport; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D012964:Sodium / Q000378:metabolism; D044465:White People
D000959:Antihypertensive Agents; D012964:Sodium