Saunders E
Division of Hypertension, University of Maryland School of Medicine and Hospital, Baltimore 21201.
J Fam Pract. 1988 Jun;26(6):659-64.
In prior years the major differences noted between hypertension in black and white patients have been mostly epidemiological, with some suggestion that the differences were primarily quantitative and probably not qualitative. Recently, certain pathophysiological aberrations in hypertensive patients have been shown to be different in blacks and whites. Whether these differences are primary (genetic) or secondary has yet to be resolved. Nevertheless, certain racial differences may have therapeutic implications. Diuretics remain the mainstay of therapy for most hypertensive black patients. beta-Blockers and angiotensin-converting enzyme (ACE) inhibitors have not shown great efficacy when used as monotherapy in black hypertensive patients. The combination of a diuretic with beta-blockers or ACE inhibitors, however, has been shown to abolish black-white differences in drug response. More recently, the calcium channel blockers have been shown to be potentially effective in black hypertensive patients. In spite of the effective drug therapy that is available for hypertensive patients in general, economic and social considerations continue to contribute to the low rate of detection, treatment, and control of hypertension in the black population.
在过去几年中，黑人与白人高血压患者之间的主要差异大多体现在流行病学方面，有迹象表明这些差异主要是数量上的，可能并非质量上的。最近，已证明高血压患者的某些病理生理异常在黑人和白人中有所不同。这些差异是原发性（遗传）的还是继发性的尚未得到解决。然而，某些种族差异可能具有治疗意义。利尿剂仍然是大多数黑人高血压患者治疗的主要手段。β受体阻滞剂和血管紧张素转换酶（ACE）抑制剂在黑人高血压患者中作为单一疗法使用时并未显示出显著疗效。然而，利尿剂与β受体阻滞剂或ACE抑制剂联合使用已被证明可消除药物反应中的黑白差异。最近，钙通道阻滞剂已被证明对黑人高血压患者可能有效。尽管一般高血压患者可获得有效的药物治疗，但经济和社会因素继续导致黑人人群中高血压的低检出率、低治疗率和低控制率。
