The management of hypertensive disease in Black patients

The ethnic differences in the incidence, pathophysiology and management of hypertensive disease, are particularly pertinent to the Black or Afro-Carib bean populations, who have a high prevalence of hypertension and associated complications, such as strokes and renal impairment. Our understanding of the underlying pathophysiology of hypertensive disease and the optimal trea tment of hypertension in Black patients continues to evolve, especially wit h the introduction of new drugs and the need for prognostic data in this et hnic population. We review the management of hypertensive disease in the bl ack population, emphasizing race-related differences in the pathophysiology of hypertension and the importance of tailored management in this group of patients, including sensible application of nonpharmacological measures wi th effective antihypertensive agents. For example, diuretics and calcium an tagonists are suitable first-line agents in black hypertensives, whilst bet a-blockers and the ACE inhibitors tend to be less effective at lowering blo od pressure, due to the low renin state in these patients.