Management of essential hypertension in the black patient: profiling as the initial approach to treatment.

The pathophysiology and course of hypertensive cardiovascular disease in the black population differ significantly from those of nonblacks. The hemodynamic and endocrine profiles are different, consequences of hypertension are more severe in blacks, and black patients are often less responsive to standard antihypertensive treatment. Safe and efficacious treatment can be achieved when drug therapy is directed at the specific underlying pathophysiologic abnormality in black patients. By closely matching cardiovascular pathophysiologic findings in a given patient with the pharmacologic effects of an antihypertensive agent, blood pressure can often be controlled with fewer adverse effects. In addition, blood flow to target organs and their function can be maintained or improved. Calcium channel blockers are especially well suited for the treatment of essential hypertension in black patients.