Hypertension in black patients: special issues and considerations.

The excess risk for hypertension in black Americans continues to be a major health concern. Although there is considerable information regarding these disease trends, many of the major underpinnings of the etiology of hypertension remain unclear. The excess mortality in blacks due to heart disease, renal failure, and stroke is clearly directly related to the excess burden of hypertension. Amid the recent findings about the pathophysiology of hypertension, some clear differences in the effects of overweight, salt sensitivity, and vascular biology emerge along ethnic lines. These differences may shed some light on the development of more effective treatment strategies. Based on our current knowledge, aggressive management of hypertension in blacks is critical. This review highlights what is known about various factors affecting hypertension and its treatment in black Americans.