Key result
The pathogenesis of hypertension in African Americans is multifactorial, involving genetic influences like epithelial sodium channel polymorphisms and environmental factors such as obesity.
The aggressive end-organ manifestations of hypertension in African Americans are driven by a complex interplay of genetic polymorphisms and environmental factors like obesity.
May warrant ethnicity-informed hypertension strategies; leaves open optimal interventions for prospective trials.
Hypertension is a compelling disease process that disproportionately affects African Americans. It is the single largest risk factor for cardiovascular disease in African Americans. The end organ manifestations of hypertension are striking and include higher rates of stroke, significantly increased renal disease including end-stage renal disease requiring dialysis, higher risk of left ventricular hypertrophy, and an associated higher risk of heart failure. The cause of these more aggressive end organ phenomena is likely multifactorial and includes a mix of genetic and environmental influences. Intriguing polymorphisms of the epithelial sodium channel are consistent with patterns of hypertension seen in African Americans. Obesity, especially in African-American women, may be closely related to hypertension as a result of sympathetic nervous system stimulation.
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Nesbitt et al. (2004) conducted a review in Hypertension in African Americans. The pathogenesis of hypertension in African Americans is multifactorial, involving genetic influences like epithelial sodium channel polymorphisms and environmental factors such as obesity.
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