Related Experiment Video

Updated: May 10, 2026

The Antihypertensive Effects and Mechanisms of Huotan Jiedu Tongluo Decoction in Rats with H-Type Hypertension
05:57

The Antihypertensive Effects and Mechanisms of Huotan Jiedu Tongluo Decoction in Rats with H-Type Hypertension

Published on: May 17, 2024

Treatment of hypertension among African Americans: the Jackson Heart Study

Jane Harman1, Evelyn R Walker, Vicki Charbonneau

  • 1Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD 20892-7936, USA. Jane.Harman@nih.gov

Journal of Clinical Hypertension (Greenwich, Conn.)
|June 5, 2013
PubMed

Insights

Hypertension treatment in African Americans showed improved blood pressure control over time. Thiazide diuretics were more effective than calcium channel blockers for reaching blood pressure targets.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Pharmacotherapy

Background:

  • Hypertension is a major risk factor for cardiovascular disease, particularly prevalent in African American adults.
  • Effective blood pressure management is crucial for reducing hypertension-related morbidity and mortality.
  • Understanding treatment patterns and outcomes in specific populations like African Americans is essential for targeted interventions.

Purpose of the Study:

  • To evaluate hypertension treatment regimens and blood pressure control in African American adults participating in the Jackson Heart Study.
  • To compare the effectiveness of different antihypertensive medication classes, specifically thiazide diuretics and calcium channel blockers.
  • To identify factors associated with achieving blood pressure targets in this population.

Main Methods:

  • Analysis of data from the Jackson Heart Study, including two clinical examinations (Exam I: 2000-2004, Exam II: 2005-2008).
  • Inclusion of 2415 treated hypertensive participants at Exam I and 2577 at Exam II.
  • Assessment of blood pressure control based on established guidelines (e.g., Seventh Report of the Joint National Committee).

Main Results:

  • Blood pressure below 140/90 mm Hg was achieved by 66% (Exam I) and 70% (Exam II) of treated participants.
  • Treatment targets were met by 56% (Exam I) and 61% (Exam II) of participants.
  • Thiazide diuretics were the most common medication and were associated with better blood pressure control compared to other agents.
  • Men and individuals with diabetes or chronic kidney disease were less likely to achieve blood pressure targets.
  • Thiazide monotherapy demonstrated superior efficacy over calcium channel blocker monotherapy for achieving target blood pressure.

Conclusions:

  • While blood pressure control improved over time in the Jackson Heart Study cohort, significant proportions remained below treatment targets.
  • Thiazide diuretics appear to be a more effective first-line monotherapy for hypertension in African American adults compared to calcium channel blockers.
  • Further research and tailored treatment strategies are needed to optimize hypertension management in African American men and those with comorbidities.

Related Concept Videos

Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.