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Hypertension is a significant health issue in the West Indies. Effective management involves diuretics and beta-blockers, considering cultural beliefs for community programs.
Area of Science:
- Cardiology
- Public Health
- Pharmacology
Background:
- Hypertension is the most prevalent chronic disease in the West Indies, contributing significantly to mortality.
- Common complications include renal failure, stroke, and cardiac failure; myocardial infarction is less common in black patients.
- Cultural beliefs in the West Indies influence healthcare-seeking behaviors for hypertension management.
Purpose of the Study:
- To evaluate the effectiveness of beta-blockers and diuretics in treating hypertension in West Indian populations.
- To understand the role of cultural beliefs in hypertension management programs within the community.
Main Methods:
- Review of recent clinical experience with beta-blockers and diuretics in West Indian hypertensives.
- Analysis of factors influencing hypertension management, including cultural beliefs.
Main Results:
- Beta-blockers are effective, particularly when co-administered with diuretics, for West Indian patients.
- Higher doses of beta-blockers may be necessary compared to European and North American recommendations.
- Thiazide diuretics demonstrate efficacy in lowering blood pressure, even at low doses.
Conclusions:
- Combined therapy with diuretics and beta-blockers is effective for hypertension in West Indians.
- Tailoring hypertension management programs to incorporate cultural beliefs is crucial for community-wide success.
Abstract:
Hypertension is the most common chronic disease in the West Indies, and is a major health problem today being among the 10 most common causes of death in the English-speaking territories of the region. Most patients have essential hypertension. Renal failure, stroke, and cardiac failure are the most common complications, myocardial infarction being relatively uncommon in black patients. While an earlier report from the Caribbean suggested that beta-blockers were not effective for treating black hypertensives, recent experience with these drugs show that they are useful particularly when administered along with a diuretic. Beta-blockers may be required in higher doses than those commonly recommended for patients in Europe and North America, but even small doses of thiazide diuretics are effective in lowering the blood pressure of West Indian hypertensives. West Indians show a combination of personalistic, naturalistic, and modern medical beliefs, which need to be understood in order to mount effective programmes for the management of hypertension in the community.