CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

October 4th, 2010

Consensus Statement Highlights Urgency of Treating Hypertension in Blacks

Hypertension in blacks should be treated earlier and more aggressively, according to an update of the International Society on Hypertension in Blacks (ISHB) consensus statement published in Hypertension. The update lowers the threshold for treatment and recommends that:

  • Lifestyle changes be initiated in African-Americans when blood pressure is at or above 115/75 mm Hg.
  • Drug therapy be initiated when blood pressure is at or above 135/85 mm Hg for primary prevention and 130/80 mm Hg for secondary prevention.
  • Physicians employ combination drug therapy earlier than previously (the update makes specific recommendations for choosing drugs with numerous options for individualizing therapy).

“Evidence from several recently completed studies converged to convince our committee that we were waiting a little bit too long to start treating hypertension in African-Americans,” said the lead author of the statement, John Flack, in a press release from the AHA. “The majority of patients of any race, and certainly African-Americans, are going to need more than one drug to be consistently controlled below their goal. The debate in the medical community over which single drug is best overwhelms the most pressing question: Which drugs work best together?”

Categories: Prevention
Tags: , ,


You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.

One Response to “Consensus Statement Highlights Urgency of Treating Hypertension in Blacks”

  1. Robin Motz, M.D., Ph.D. says:
    October 4, 2010 at 9:55 pm

    But haven’t we known for a long time that (a) the only proven benefit of lowering blood pressure is reducing the risk of CVA’s, and (b) blacks are at a higher risk for hypertensive strokes than whites? I tell all my black,hypertensive patients that they cannot ignore genetics, just as Inca Indians are at higher risk for duodenal ulcers because they all have type “O” blood.