Systemic hypertension in blacks: an overview of current concepts of pathogenesis and management.

Systemic hypertension is a leading risk factor for cardiovascular disease among Blacks. Essential hypertension in this population is dominantly related to salt-sensitivity acting via various interactive mechanisms including volume changes, nitric oxide inactivation, angiotensin II and insulin resistance. Excess morbidity and mortality among Black hypertensives are related to twin problems of ignorance and poverty, late diagnosis, genetically determined racial biological factors and co-existing diabetes mellitus and obesity arising from "western" adopted affluent life-style. This paper reviews these peculiarities and their implications in the management of a Black Hypertensive.