05/07/2007
What is the best treatment for hypertension in African Americans?
EVIDENCE-BASED ANSWER
In African Americans with hypertension, therapy is best initiated with the low-sodium Dietary Approaches to Stop Hypertension (DASH) diet and a thiazidetype diuretic (strength of recommendation [SOR]: A, based on randomized controlled trials). If the blood pressure goal is not achieved with thiazide monotherapy, a calcium channel blocker, angiotensin-converting enzyme (ACE) inhibitor, angiotensin II receptor blocker (ARB), or a beta-blocker can be added. An initial combination treatment is recommended for patients with systolic blood pressure >15 mm Hg or diastolic blood pressure >10 mm Hg above target (SOR: C, expert opinion).
African Americans have reduced blood pressure responses to monotherapy with beta-blocker, ACE inhibitor, or ARBs when compared to diuretics or calcium channel blockers (SOR: A, randomized controlled trials). However, cardiac and renal indications for prescribing these medications should be equally applied to African American patients (SOR: C, expert opinion).
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treatment of hypertension
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ttreatment of hypertension - trreatment of hypertension - treeatment of hypertension - treaatment of hypertension - treattment of hypertension - treatmment of hypertension - treatmeent of hypertension - treatmennt of hypertension - treatmentt of hypertension - treatment of hypertension - treatment oof hypertension - treatment off hypertension - treatment of hypertension - treatment of hhypertension - treatment of hyypertension - treatment of hyppertension - treatment of hypeertension - treatment of hyperrtension - treatment of hyperttension - treatment of hyperteension - treatment of hypertennsion - treatment of hypertenssion - treatment of hypertensiion - treatment of hypertensioon - treatment of hypertensionn -
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