Doctors Call for More Aggressive Treatment of Hypertension in Blacks

Most blacks with hypertension require "more aggressive treatment" and should take at least two medications, according to new guidelines from the International Society of Hypertension in Blacks published today in the Archives of Internal Medicine, the Baltimore Sun reports. Under the guidelines, physicians should prescribe to black patients with hypertension two medications, such as a diuretic and an ACE inhibitor, rather than wait to determine the effectiveness of a single treatment. Physicians also should recommend exercise, weight loss and the Dietary Approaches to Stop Hypertension diet, which includes large amounts of fruits, vegetables and fiber, the guidelines said (Bor, Baltimore Sun, 3/11). The guidelines also recommend that blacks with diabetes, heart disease and/or mild kidney disease should have a blood pressure level of 130 over 80. The guidelines, endorsed by the American Heart Association Council on High Blood Pressure Research and other groups, mark the first specific recommendations for blacks with hypertension; more than one-third of black men in the United States have hypertension, compared with about one-fourth of white men. "This represents a huge problem, and we believe that the recommendations ... will result in a reduction of this huge burden of disease on African-Americans," Ernesto Schiffrin, chair of the AHA council, said (Tanner, AP/Nando Times, 3/10). The guidelines are available online.