Medical Interventions for African-American Males With Hypertension

Hypertension / High Blood Pressure

What are the symptoms of hypertension and what are the reasons that people get hypertension? What ethnicities are most prone to hypertension? The answer is that African-Americans are most prone to hypertension -- in particular male African-Americans over the age of 60. What is the best treatment for hypertension for those older African-American males? This paper discusses these issues using available literature.

Hypertension

Hypertension is a problem with people worldwide and is found in all populations "except some primitive communities that live in cultural isolation" (Nadar, 2015). Hypertension is caused by "abnormally elevated blood pressures" and is often called the "silent killer" because people don't always know they have hypertension, Nadar writes on page 3 of his book. About 6% of adult deaths in the whole world result from hypertension, and the first signs of hypertension often are diagnosed when a person suffers a "myocardial infarction or a stroke" (Nadar, 3).

Treating Hypertension -- for any Race or Ethnicity

The National Institutes of Health (NIH) first of all suggests "healthy lifestyle habits" as a way to control high blood pressure (HBP). Becoming physically active, maintaining a healthy weight, avoiding smoking and trying to manage stress are recommendations at the top of the list of ways to treat hypertension. As for medicines, NIH suggests diuretics, beta blockers, ACE inhibitors, angiotensin II receptor blockers, and alpha blockers.

African-American Men and Hypertension

African-Americans have "significantly higher" blood pressure in routine examinations than non-African-Americans do (Gulledge, et al., 1999). Older age and being an African-American are "independent predictors of diastolic blood pressure increases," Gulledge explains on page 54. Noncompliance with drug therapy and high rates of hypertension patient "dropout rates" are associated with African-Americans for a number of reasons, including the fact that low income populations in inner cities are exposed to poor environments and a lack of access to health care, Gulledge explains.

Drug Interventions for African-American Males with Hypertension

Diuretics are more effective in treating hypertension in African-Americans than in Caucasians, Gulledge explains, but angiotensin-converting enzyme (ACE) inhibitors and beta blockers are "not as effective" (54).

The peer-reviewed Medscape articles on treating African-Americans does not offer dosage and scheduling of medications but it does offer interventions. Dr. John Flack, et al., writes in the American Journal of Cardiovascular Drugs that most African-American male patients' hypertension will "not be controlled to below goal BP levels consistently over the long-term with single-drug therapy" (Flack, et al., 2011). But a monotherapy approach with a thiazide diuretic or a calcium channel antagonist" has lowered the blood pressure of African-Americans more consistently and effectively than "?-adrenoceptor antagonists (?-blockers), ACE inhibitors, and angiotensin 11 type 1 receptor antagonists (angiotensin receptor blockers)" (Flack, p. 1).