PREVALENCE OF COMPLICATIONS AND RESPONSE TO DIFFERENT TREATMENTS OF HYPERTENSION IN AFRICAN-AMERICANS AND WHITE AMERICANS IN THE UNITED-STATES

The aim of this review is to compare the prevalence of complications a nd response to different treatment for hypertension in African and Eur opean Americans. African Americans when compared to European Americans respond less favorably to beta-blockers (BB's) and angiotensin conver ting enzyme inhibitors (ACEI's). Nevertheless the observed response of African Americans to ACEI's and BB's is significant and these agents are very effective in this subgroup. African American race is not a cl inically significant predictor of poor response to any class of antihy pertensive therapy and there is little justification to use racial pro filing as a criterion for choice of medication. Evidence to restrict o r defer usage of BB's and ACEI's in African Americans is lacking. The mortality from hypertensive heart disease, stroke, and the incidence o f hypertensive renal disease is higher in African Americans which lead s some investigators to postulate that hypertension in African America ns is intrinsically different from whites. They therefore search for a separate etiology and suggest specific approaches to treatment. Aware ness of racial differences in hypertension outcomes evolved in the U.S . in an historical context that does not fully appreciate that race is often a surrogate for many social and economic factors that influence health status and health care delivery in the U.S. Poor outcomes in A frican Americans occur in many diseases including hypertension.