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Metabolic considerations in the treatment of the black hypertensive
1Hypertension Research Center, Indiana University School of Medicine, Indianapolis 46202-5111.
Insights
Black Americans with hypertension benefit from specific antihypertensive agents that reduce cardiovascular disease risks. This review focuses on non-diuretic therapies for improved efficacy and metabolic outcomes.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Hypertension and its cardiovascular complications are highly prevalent and severe in Black Americans.
- Evidence indicates varying efficacy and cardiovascular benefits among antihypertensive medications.
- Certain patient populations may not respond optimally to all drug classes.
Purpose of the Study:
- To review the efficacy of different antihypertensive agents specifically in Black patients.
- To assess the impact of these agents on cardiovascular disease risk factors and comorbidities common in this demographic.
- To emphasize non-diuretic therapeutic strategies for enhanced cardiovascular and metabolic benefits.
Main Methods:
- Literature review of clinical studies and evidence.
- Analysis of antihypertensive agent efficacy in Black populations.
- Evaluation of effects on cardiovascular risk factors and metabolic parameters.
Main Results:
- Efficacy of antihypertensive agents differs significantly in Black patients.
- Non-diuretic agents, particularly calcium channel blockers and ACE inhibitors, show promise.
- Impact on metabolic factors like diabetes and lipid profiles varies by drug class.
Conclusions:
- Therapeutic strategies for hypertension in Black Americans should be individualized.
- Non-diuretic antihypertensive agents may offer superior cardiovascular and metabolic benefits in this population.
- Further research is warranted to optimize treatment regimens for Black hypertensives.
Abstract:
Hypertension and its cardiovascular consequences are both common and potentially devastating among black Americans. Recent evidence suggests that not all antihypertensive agents have similar efficacy in hypertensive patients, nor do all convey the same benefit in terms of reducing the risk of cardiovascular disease. This review considers the efficacy of various antihypertensive agents in blacks, with particular reference to the impact of these agents on cardiovascular disease risk factors and on associated diseases often encountered in black hypertensives. Emphasis is placed on the use of therapeutic approaches other than diuretics alone or in combination with other antihypertensive agents from the vantage point of efficacy and enhancement of cardiovascular and metabolic benefits.