Tailoring treatment to minority patients

Article Abstract:

High blood pressure (hypertension) is a particularly important health problem in the black population. The incidence of mild and moderate hypertension among blacks is one and one half to two times that of whites, and the rate of severe hypertension is five to seven times greater among blacks. Mortality from cardiovascular disease is similarly elevated for this group; it is estimated to be three to five times that of the white population. Black persons are also at greater risk for the life-threatening complications of hypertension, which include kidney disease and stroke. One reason for these racial differences may be access to medical care, which is frequently limited for minority groups; another may be the misconception that blacks do not respond well to drug therapy for hypertension. However, certain types of antihypertensive drugs are more effective in treating specific racial groups. Blacks with high blood pressure respond better to diuretics, and less well to beta-blockers and angiotensin-converting enzyme inhibitors compared with whites. Once black hypertensives obtain care for their high blood pressure, they can be treated just as quickly and effectively as white patients. Diuretics are a good first choice for antihypertensive treatment in newly diagnosed black patients because they have been proven effective in this population, are easy to comply with since they are taken only once a day, and are less expensive than other drugs. When appropriate, the combination of diuretics with another antihypertensive drug may increase efficacy of therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diuretics

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Hypertension treatment results in minority patients

Article Abstract:

High blood pressure (hypertension) is often undiagnosed and untreated in patients of certain minority backgrounds, particularly blacks and Hispanics. Little is known of the ability of drug treatment to reduce illness and death in these patients over the long term. The data that are currently available on this topic are reviewed. These studies indicate that reduction of high blood pressure in black patients can be achieved on an ongoing basis, which results in the substantial benefit of reducing the rate of cardiovascular disease and death. The physician's decision of which antihypertensive drug to use is important. When compared with whites, blacks respond better to some drugs (thiazide diuretics and calcium entry blockers), and less well to others (beta-blockers and converting enzyme inhibitors). This trend applies to the use of a single drug treatment (monotherapy); but when two antihypertensives are combined, a drug that is ineffective alone may enhance the effect of the other drug. While more blacks than whites have diabetes and left ventricular hypertrophy (enlargement of one of the chambers of the heart), these problems need not determine the choice of hypertension treatment. The benefits of long-term drug therapy for hypertension in Hispanic and Asian populations have received minimal research attention. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality

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Similar abstracts:

• Abstracts: Making a difference: managing hypertension in minority patients. Hypertension and cardiac disease in minorities
• Abstracts: Hypertension in the Hispanic-American population. Hypertension in minority populations: access to care

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