oa Cardiovascular Journal of Africa - Clinicopharmacological aspects of hypertension in the black population



Hypertension is a major disease in the black populations of sub-Saharan Africa and the USA. The prevalence of hypertension varies from 1-30% in the adult population. Differences in blood pressure between black and white patients have been documented. In this review genetic, endocrine and� environmental characteristics, renal physiology and cardiac function are reviewed. Racial differences in renal physiology and socio-economic status seem to account for blood pressure differences. Black hypertensive patients in sub-Saharan Africa are prone to cerebral haemorrhage, malignant hypertension leading to uraemia and congestive heart failure, whereas coronary artery disease is uncommon. Responses to hypotensive agents like l3-blockers and angiotensin-converting enzyme inhibitors are poor unless these agents are combined with a thiazide diuretic. Black hypertensive patients respond best to diuretics, vasodilators or calcium channel blockers. A profiled approach to the treatment of hypertension is suggested.


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