HYPERTENSION AND CARDIOVASCULAR-DISEASE IN BLACKS

Differences in the prevalence and severity of hypertension and vascular disease between blacks and whites continue to be unexplained, but comparisons of cardiovascular and metabolic disease prevalences in Mexican and Native Americans with those in blacks and whites have sharpened the focus. Whereas obesity and diabetes are frequent in all three minority groups compared with whites, hypertension is common only in blacks. Studies of target organ damage continue to indicate greater severity in blacks than whites. As for nephrosclerosis, there is growing evidence that factors in addition to hypertension are responsible for progression to renal failure. Antihypertensive drug therapy, however, remains an imperative and the debate continues about blood pressure responsiveness to specific agents. The recently reported Systolic Hypertension in the Elderly study showed that systolic hypertension in blacks responded as well to treatment as it did in whites, and that black women had the greatest reduction of stroke incidence of all race and sex groups.