The disproportionate impact of hypertensive cardiovascular disease in African Americans: getting to the heart of the issue.

The prevalence of hypertension in African Americans is among the highest in the world. Persons in this group develop hypertension at a younger age than non-African Americans and develop more severe complications, including stroke, cardiovascular disease, and renal failure. The factors that impart this high risk to this population remain poorly understood and, undoubtedly, environmental factors overshadow genetic predisposition. While identifying the pathophysiologic and environmental factors that contribute to ethnic disparity in disease is important, finding a long-term solution is crucial. Steps that can have an important impact on health outcomes of African Americans are presently available. Awareness of ethnicity as a risk factor for hypertension can allow health care providers to identify persons who are likely to benefit most from early, aggressive intervention. Modifiable factors such as smoking, diet, and sedentary lifestyle, as well as undertreatment of hypertension by physicians, can be targeted immediately.