Therapy of Hypertension in African Americans

John M. Flack; Samar A. Nasser; Phillip D. Levy


Am J Cardiovasc Drugs. 2011;11(2):83-92. 

In This Article

2. Resistant Hypertension

African American patients with hypertension have been routinely characterized as a difficult to treat population subgroup. Control of BP to less than target levels (<140/90 mmHg) in African Americans with hypertension occurs less often than in their White counterparts.[3] It also appears that African Americans with hypertension manifest more of the individual characteristics/co-morbidities (i.e. albuminuria, depressed kidney function, obesity, target-organ injury, diabetes, and severe BP elevations) that have been linked to antihypertensive drug resistance and therefore lesser overall attainment of hypertension control.[11,22] However, whether such poor BP control reflects true resistant hypertension or a confluence of other contributory factors such as therapeutic inertia, patient non-compliance, or socioeconomic status is unclear. Nevertheless, the prevalence of resistant hypertension (BP above goal levels while taking three adequately dosed antihypertensive medications of different drug classes, one of which is a diuretic, or BP below goal levels while taking at least four antihypertensive drugs of different classes, one of which is a diuretic) is more common in African Americans than in Whites.[23]


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