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Special Article |

Management of High Blood Pressure in African Americans Consensus Statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks

Janice G. Douglas; George L. Bakris; Murray Epstein; Keith C. Ferdinand; Carlos Ferrario; John M. Flack; Kenneth A. Jamerson; Wendell E. Jones; Julian Haywood; Randall Maxey; Elizabeth O. Ofili; Elijah Saunders; Ernesto L. Schiffrin; Domenic A. Sica; James R. Sowers; Donald G. Vidt ; the Hypertension in African Americans Working Group
Arch Intern Med. 2003;163(5):525-541. doi:10.1001/archinte.163.5.525.
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The purpose of this consensus statement is to offer primary care providers (including physicians, nurse practitioners, and physician assistants) a practical, evidence-based clinical tool for achieving blood pressure goals in African American patients. The need for specific recommendations for African Americans is highlighted by compelling evidence of a higher prevalence of hypertension and poorer cardiovascular and renal outcomes in this group than in white Americans. African Americans have disturbingly higher rates of cardiovascular mortality, stroke, hypertension-related heart disease, congestive heart failure, type 2 diabetes mellitus, hypertensive nephropathy, and end-stage renal disease (ESRD).1,2

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Clinical algorithm for achieving target blood pressure (BP) in African American patients with high BP. RAS indicates renin-angiotensin system. Asterisk indicates to initiate monotherapy at the recommended starting dose with an agent from any of the following classes: diuretics, β-blockers, calcium channel blockers (CCBs), angiotensin-converting enzyme (ACE) inhibitors, or angiotensin II receptor blockers (ARBs). Dagger indicates to initiate low-dose combination therapy with any of the following combinations: β-blocker/diuretic, ACE inhibitor/diuretic, ACE inhibitor/CCB, or ARB/diuretic.

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