The updated consensus statement on hypertension management in blacks recommends target blood pressures of <135/85 mm Hg for primary prevention and <130/80 mm Hg for secondary prevention.
What are the optimal blood pressure targets and pharmacological treatment strategies for managing hypertension in Black patients?
This consensus statement provides updated, more stringent blood pressure targets and specific pharmacological recommendations for managing hypertension in Black patients.
Since the first International Society on Hypertension in Blacks consensus statement on the "Management of High Blood Pressure in African American" in 2003, data from additional clinical trials have become available. We reviewed hypertension and cardiovascular disease prevention and treatment guidelines, pharmacological hypertension clinical end point trials, and blood pressure-lowering trials in blacks. Selected trials without significant black representation were considered. In this update, blacks with hypertension are divided into 2 risk strata, primary prevention, where elevated blood pressure without target organ damage, preclinical cardiovascular disease, or overt cardiovascular disease for whom blood pressure consistently 15/10 mm Hg above target, 2-drug therapy is recommended, with either a calcium channel blocker plus a renin-angiotensin system blocker or, alternatively, in edematous and/or volume-overload states, with a thiazide diuretic plus a renin-angiotensin system blocker. Effective multidrug therapeutic combinations through 4 drugs are described. Comprehensive lifestyle modifications should be initiated in blacks when blood pressure is ≥115/75 mm Hg. The updated International Society on Hypertension in Blacks consensus statement on hypertension management in blacks lowers the minimum target blood pressure level for the lowest-risk blacks, emphasizes effective multidrug regimens, and de-emphasizes monotherapy.
Flack et al. (2010) conducted a review in High blood pressure in Blacks. Updated hypertension management guidelines was evaluated. The updated consensus statement on hypertension management in blacks recommends target blood pressures of <135/85 mm Hg for primary prevention and <130/80 mm Hg for secondary prevention.
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