Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Clinical Research & Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA.
Curr Cardiol Rep. 2024 Nov;26(11):1163-1171. doi: 10.1007/s11886-024-02115-5. Epub 2024 Sep 5.
Elevated blood pressure is the leading modifiable risk factor for cardiovascular morbidity and mortality in the US. Older individuals, Black adults, and those with comorbidities such as chronic kidney disease, have higher levels of uncontrolled and resistant hypertension. This review focuses on resistant hypertension, specifically in the US Black population, including potential benefits and limitations of current and investigational agents to address the disparate toll.
There is a necessity to implement public health measures, including early screening, detection, and evidence-based hypertension treatment with lifestyle, approved and investigational agents. The evidence highlights the importance of implementing feasible and cost-effective public health measures to advocate for early screening, detection, and appropriate treatment of hypertension. A team-based approach involving physicians, advanced practice nurses, physician assistants, pharmacists, social workers, and clinic staff to implement proven approaches and the delivery of care within trusted community settings may mitigate existing disparities.
高血压是美国心血管发病率和死亡率的主要可改变风险因素。老年人、黑种人和患有慢性肾脏病等合并症的人群，其未得到控制和耐药性高血压的水平更高。本综述重点介绍了耐药性高血压，特别是在美国黑人群体中，包括当前和正在研究的药物治疗的潜在益处和局限性，以解决这一差异造成的影响。
有必要实施公共卫生措施，包括早期筛查、检测和基于生活方式、已批准和正在研究的药物治疗高血压。这一证据强调了实施可行且具有成本效益的公共卫生措施的重要性，以倡导早期筛查、检测和适当治疗高血压。一个由医生、高级执业护士、医师助理、药剂师、社会工作者和诊所工作人员组成的团队，采用经过验证的方法，并在值得信赖的社区环境中提供护理，可以减轻现有的差异。
