Is the pathogenesis of hypertension different in black patients?

There is a higher prevalence of hypertension in the urban black population of South Africa and the USA in comparison to whites living in the same geographical areas. Several factors including age, urbanisation, socioeconomic status and acculturation contribute to the differences in the prevalence of hypertension between blacks and whites. In addition there may be a genetic element. Biochemical differences in the lipid profile of the blacks in Sub-Saharan Africa may play an Important role in the lower incidence of coronary heart disease. Blacks have an abnormal transport mechanism of sodium. There are varying responses to antihypertensive drugs in blacks compared to whites. It is probable that with a better understanding of the pathogenesis of hypertension in blacks, we will be able to reduce the high prevalence, prevent complications and institute more effective treatment and control of hypertension.