title: Hypertension in minority populations: new guidelines and emerging concepts.
abstract: Persistent disparities in hypertension, CKD, and associated cardiovascular disease have been noted in the United States among racial/ethnic minority groups. Overall, these disparities are largely mediated by social determinants of health. Yet, emerging data suggest additional biologic factors in racial/ethnic disparities in hypertension prevalence, complications, particularly CKD, and responses to treatment. Nevertheless, race is a social construct and not a physiologic concept, and ethnicity, federally defined as the binary "Hispanic/Latino" or "not Hispanic/Latino," is also imprecise. However, race/ethnicity categories may help interpret health-related data, including surveillance and research, and are important in ensuring that clinical trials remain generalizable to diverse populations. There is significant heterogeneity among prespecified groups and, perhaps, greater genetic differences within than between certain racial/ethnic groups. This review will explore hypertension epidemiology, pathophysiology, and management among the diverse and growing US minority groups, specifically African Americans and Hispanics because much less data are available across the wide spectrum of diverse populations. We will highlight the intersection of hypertension and increasingly prevalent CKD, particularly in African Americans. Finally, we propose multidimensional treatment approaches to hypertension among diverse populations, encompassing population, community, health system, and individual-based approaches.
authors.affiliation: Department of Cardiovascular Medicine, Stanford University, Palo Alto, CA; and Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA.
authors.forename: Fátima
authors.initials: F
authors.lastname: Rodriguez
authors.affiliation: Department of Cardiovascular Medicine, Stanford University, Palo Alto, CA; and Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA. Electronic address: kferdina@tulane.edu.
authors.forename: Keith C
authors.initials: KC
authors.lastname: Ferdinand
mesh_terms: D001741:Black or African American; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D019468:Disease Management; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents
keywords: Chronic kidney disease; Disparities; Guidelines; Hypertension; Racial/ethnic minorities