Hypertension is a leading
risk factor for
cardiovascular disease, which includes
coronary heart disease,
heart failure and
stroke. This article examines the possible benefits and potential pitfalls of utilizing race-based categories for
antihypertensive therapy. Although the use of race and ethnicity to guide
antihypertensive treatment is fraught with difficulty and is, to a large extent, inadequate, there may be benefit in recognizing specific aspects of race and ethnicity when approaching patients with
hypertension. Evidence from
clinical trials, including
drug efficacy and safety comparisons and
cardiovascular outcomes, has demonstrated some differences based on race/ethnicity. American federal standards strongly encourage capturing data on race/ethnicity, and most of the current data are available for self-described African-Americans. International studies increasingly identify race/ethnicity, although the data are not as robust as in US trials. Current guidelines recommend
thiazide diuretics and/or long-acting
calcium channel blockers as initial treatment for Blacks, although
medications for compelling indications agents should be prescribed, regardless of race/ethnicity.
