Aggressive treatment recommended for blacks with high blood pressure

CHICAGO (AP) _ Most blacks with high blood pressure need aggressive treatment, including at least two drugs to effectively control hypertension, new guidelines say. <br><br>The recommendations from the

Monday, March 10th 2003, 12:00 am

By: News On 6

CHICAGO (AP) _ Most blacks with high blood pressure need aggressive treatment, including at least two drugs to effectively control hypertension, new guidelines say.

The recommendations from the International Society on Hypertension in Blacks are billed as the first-ever high blood pressure guidelines specifically for blacks, who are disproportionately affected by hypertension and related complications.

But the new guidelines could be applied to anyone with hypertension and high-risk conditions including diabetes and kidney disease, said Dr. John Flack of Wayne State University, the society's president.

``Good hypertension treatment is good hypertension treatment, irrespective of race,'' Flack said.

The guidelines appear in Monday's Archives of Internal Medicine. They have been endorsed by several medical groups, including the American Heart Association's Council on High Blood Pressure Research.

``This represents a huge problem, and we believe that the recommendations ... will result in a reduction of this huge burden of disease on African-Americans,'' said Dr. Ernesto Schiffrin, chairman of the AHA council.

About 50 million Americans have high blood pressure, including more than a third of black men, compared with about one-fourth of white and Mexican-American men. Black women are also disproportionately affected.

Blacks in general are more likely than whites to suffer related complications. They face nearly double the risk of fatal strokes and a four times higher risk of severe kidney disease.

The reasons for the disparities are uncertain, though some researchers think genetics and lack of access to health care may play a role.

Doctors generally recommend that otherwise healthy patients keep their blood pressure under 140 over 90. This can often be achieved through diet and exercise.

The new guidelines say blacks with diabetes, heart disease or mild kidney disease should strive for a reading lower than 130 over 80, and most will not be able to achieve that without taking at least two blood pressure-lowering medications, Schiffrin said.

The guidelines say two medications should be used when hypertension significantly exceeds those target levels. That involves levels at least 15 points above the desired top reading (systolic pressure) and 10 points higher than the bottom reading (diastolic) pressure. For example, black diabetics should use two medications if their blood pressure is 145 over 90 or higher.

Flack said about 70 percent of blacks with hypertension, compared with about half of whites, would require at least two drugs to lower blood pressure. The recommended drug combinations include diuretics with beta blockers or ACE inhibitors, he said.