Management of high blood pressure in blacks: An update of the International Society on Hypertension in Blacks consensus statement

John M. Flack, Domenic A. Sica, George Bakris, Angela L. Brown, Keith C. Ferdinand, Richard H. Grimm, W. Dallas Hall, Wendell E. Jones, David S. Kountz, Janice P. Lea, Samar Nasser, Shawna D. Nesbitt, Elijah Saunders, Margaret Scisney-Matlock, Kenneth A. Jamerson

Research output: Contribution to journalArticle

279 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)780-800
Number of pages21
JournalHypertension
Volume56
Issue number5
DOIs
StatePublished - Nov 2010

Fingerprint

Consensus
Hypertension
Blood Pressure
Cardiovascular Diseases
Renin-Angiotensin System
Sodium Chloride Symporter Inhibitors
Calcium Channel Blockers
Primary Prevention
African Americans
Hypotension
Life Style
Clinical Trials
Pharmacology
Guidelines
Drug Therapy
Therapeutics
Pharmaceutical Preparations

Keywords

  • antihypertensive therapy
  • blood pressure
  • essential hypertension
  • ethnic groups
  • hypertension detection and control
  • obesity
  • race

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Flack, J. M., Sica, D. A., Bakris, G., Brown, A. L., Ferdinand, K. C., Grimm, R. H., ... Jamerson, K. A. (2010). Management of high blood pressure in blacks: An update of the International Society on Hypertension in Blacks consensus statement. Hypertension, 56(5), 780-800. https://doi.org/10.1161/HYPERTENSIONAHA.110.152892

Management of high blood pressure in blacks : An update of the International Society on Hypertension in Blacks consensus statement. / Flack, John M.; Sica, Domenic A.; Bakris, George; Brown, Angela L.; Ferdinand, Keith C.; Grimm, Richard H.; Hall, W. Dallas; Jones, Wendell E.; Kountz, David S.; Lea, Janice P.; Nasser, Samar; Nesbitt, Shawna D.; Saunders, Elijah; Scisney-Matlock, Margaret; Jamerson, Kenneth A.

In: Hypertension, Vol. 56, No. 5, 11.2010, p. 780-800.

Research output: Contribution to journalArticle

Flack, JM, Sica, DA, Bakris, G, Brown, AL, Ferdinand, KC, Grimm, RH, Hall, WD, Jones, WE, Kountz, DS, Lea, JP, Nasser, S, Nesbitt, SD, Saunders, E, Scisney-Matlock, M & Jamerson, KA 2010, 'Management of high blood pressure in blacks: An update of the International Society on Hypertension in Blacks consensus statement', Hypertension, vol. 56, no. 5, pp. 780-800. https://doi.org/10.1161/HYPERTENSIONAHA.110.152892
Flack, John M. ; Sica, Domenic A. ; Bakris, George ; Brown, Angela L. ; Ferdinand, Keith C. ; Grimm, Richard H. ; Hall, W. Dallas ; Jones, Wendell E. ; Kountz, David S. ; Lea, Janice P. ; Nasser, Samar ; Nesbitt, Shawna D. ; Saunders, Elijah ; Scisney-Matlock, Margaret ; Jamerson, Kenneth A. / Management of high blood pressure in blacks : An update of the International Society on Hypertension in Blacks consensus statement. In: Hypertension. 2010 ; Vol. 56, No. 5. pp. 780-800.
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