Black vs Non-Black
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Yes the management could differ because although both have black color with some specific characteristic on hypertension, the afro American has the strong influence of the American society and environment, while the one living in an African country has other lower environment influence.
As you know, essential hypertension has multiple known and unknown causal factors, genetic, nutritional, environmental, etc.
Hypertension is more frequent in black, it appears early, and is more severe in blacks than in non-black, it is more sensitive to diuretics and to high salt consumption in blacks. Hypertensive blacks have poorer outcomes than whites when treated with an ACE inhibitor-based regimen.
You can get in PUBMED several reference on this item.
Best wishes
May I correct these answers?
First, essential hypertension involves an inheritable defect of low RBC-K, unrelated to normal RBC-Na, an autosomic dominant single gen, both sexes equality affected.
In fact, population studies in our Research Unit have found that families with one hypertensive parent, 52-54% of their offspring will have hypertension after aged >25 years, and 74-76% when both parents were hypertensives. Similar observations were reported by Garay RP in the 1980's, except the defective low RBC-K.
Second, such heridary defect of low RBC-K impairs several RBC-K dependent function includinmg ATP synthesis and release, most powerful vasodilator effector in presence of low pH or low PO2, and K-O2 binding by human hemoglobin, body K physiology (gastric K absorption, myocardial K regulation and renal K excretion [-0.865]), all documented in our Ion Transport Research Laboratory
Therefore, such inherited defect of low RBC-K is remarkably significant on the pathogenesis and management of hypertension and CHD.
Whatever the genetic basis in different racial groups, we follow the International Society oh Hypertension guideline Jornal of Clinical Hypertension Vol. 16; No.1; January,2014 ) to give ACEI?ARBs as first line regimen in non-black people and calcium channel bolckers & diuretics in black poeople ahich are derieved from different prospective trials.
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