期刊
HYPERTENSION
卷 56, 期 5, 页码 780-800出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/HYPERTENSIONAHA.110.152892
关键词
antihypertensive therapy; blood pressure; essential hypertension; ethnic groups; hypertension detection and control; obesity; race
资金
- National Institute of Diabetes and Digestive and Kidney Diseases
- Novartis
- National Institutes of Health
- National Heart, Lung, and Blood Institute
- COVANCE-NEB310
- Sonosite-Better HTN
- Daiichi Sankyo-3 Combo Tx in HTN
- Sanofi Aventis [DAR 311, DAR 312]
- Medpace
- PPD Development-Mannkind
- ALISKIREN
- Glaxo Smith Kline Modest and Forest Modest
- National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases [5 U01 DK 48400]
- Daiichi-Sankyo
- ISHIB Impact Study
- Forest Pharmaceuticals
- National Institutes of Health [U01 HL79151]
- Donald and Karin Allen Faculty Development Fund
- King Pharmaceuticals
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 <135/85 mm Hg is recommended, and secondary prevention, where elevated blood pressure with target organ damage, preclinical cardiovascular disease, and/or a history of cardiovascular disease, for whom blood pressure consistently <130/80 mm Hg is recommended. If blood pressure is <= 10 mm Hg above target levels, monotherapy with a diuretic or calcium channel blocker is preferred. When blood pressure is >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. (Hypertension. 2010;56:780-800.)
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