Department of Medicine, Division of Nephrology, Hypertension and Kidney Transplantation, Temple University School of Medicine, Kresge West, Suite 100, 3440 North Broad Street, Philadelphia, PA, 19140, USA.
Curr Cardiol Rep. 2017 Oct 28;19(12):129. doi: 10.1007/s11886-017-0933-z.
African Americans are over-burdened with hypertension resulting in excess morbidity and mortality. We highlight the health impact of hypertension in this population, review important observations regarding disease pathogenesis, and outline evidence-based treatment, current treatment guidelines, and management approaches.
Hypertension accounts for 50% of the racial differences in mortality between Blacks and Whites in the USA. Genome-wide association studies have not clearly identified distinct genetic causes for the excess burden in this population as yet. Pathophysiology is complex likely involving interaction of genetic, biological, and social factors prevalent among African Americans. Non-pharmacologic and pharmacologic therapy is required and specific treatment guidelines for this population are varied. Combination therapy is most often necessary and single-pill formulations are most successful in achieving BP targets. Racial health disparities related to hypertension in African Americans are a serious public health concern that warrants greater attention. Multi-disciplinary research to understand the inter-relationship between biological and social factors is needed to guide successful treatments. Comprehensive care strategies are required to successfully address and eliminate the hypertension burden.
非裔美国人患高血压的负担过重,导致发病率和死亡率过高。我们强调了该人群中高血压对健康的影响,回顾了有关疾病发病机制的重要观察结果,并概述了基于证据的治疗方法、当前的治疗指南和管理方法。
高血压占美国黑人与白人之间死亡率种族差异的 50%。全基因组关联研究尚未明确确定该人群负担过重的独特遗传原因。发病机制复杂,可能涉及非裔美国人中常见的遗传、生物和社会因素的相互作用。需要非药物和药物治疗,并且针对该人群的具体治疗指南存在差异。联合治疗通常是必需的,单片制剂在达到血压目标方面最成功。与非裔美国人高血压相关的种族健康差异是一个严重的公共卫生问题,值得引起更多关注。需要多学科研究来了解生物和社会因素之间的相互关系,以指导成功的治疗。需要综合护理策略来成功应对和消除高血压负担。