Kidney disease and hypertension in blacks.

Black Americans have relatively more hypertension and hypertensive renal disease than white Americans. The reasons for these differences are not clear and are under investigation. The genetic basis of hypertension may be different between blacks and whites. The response to systemic hypertension may also be different. Hypertensive black patients appear to develop renal arterial fibroplasia and renal insufficiency at an earlier age than white patients. Adequate control of blood pressure appears to be more effective in slowing the rate of decline in renal function among whites than among blacks. However, the available data are not sufficient. More information is needed to identify risk factors for the development of end-stage renal disease and to guide the management of hypertension in blacks.