Hypertension in blacks

Hypertension represents a problem of special importance in the black patient primarily because of frequency and increased severity. Differences between hypertension in blacks and whites in the United States seem to be mostly epidemiological, pathophysiological, and in responsiveness to drug therapy. Black hypertensives seem to have more of a salt-sensitive, volume-dependent type of hypertension and, therefore, diuretic therapy appears to be particularly useful. Agents that seem to depend more on a stimulated renin-angiotensin-aldosterone system are generally less effective as monotherapy in this group of patients. However, proper combinations of low dose diuretics, with almost any other therapeutic agent, seems to produce a responsiveness in the black hypertensive that is equal to comparable white patients.