Stepped care and profiled care in the treatment of hypertension: considerations for black Americans.

The stepped-care approach to the treatment of hypertension has proved to be effective in helping control hypertension and in reducing morbidity and mortality associated with hypertension and related cardiovascular disease. Nevertheless, modifications to the stepped-care approach can provide more effective care for certain patient subgroups. By applying the best principles of stepped care to a more individualized methodology, a "profiled-care" approach to treating hypertension has been made available. Profiled care may prove particularly valuable in treating hypertensive patients in black urban communities where all forms of hypertension are disproportionally represented because of various physical, psychosocial, and socioeconomic factors. Along with efforts by the government and private sectors to eliminate barriers to effective hypertension control in poor black communities, profiled care can help achieve control equal to that achieved in more affluent communities.