More than half of all African-Americans have high blood pressure under new diagnostic guidelines

阿纳海姆, California -- Well over half of all African-American adults will be classified as having high blood pressure under new streamlined diagnostic guidelines released this week, illuminating the heavy burden of cardiovascular disease in the population.

The guidelines change the definition of high blood pressure – also called hypertension – to begin when measurements show a top number of 130 or a bottom number of 80. 这与1993年以来的140/90相比发生了变化.

有了这个变化, it is estimated that 59 percent of all African-American men will be classified as having high blood pressure, 从42%上升. Fifty-six percent of African-American women – who had the highest rate previously at 46 percent – now have high blood pressure. Forty-seven percent of white men and 41 percent of white women have high blood pressure.

“Earlier intervention is important for African-Americans,” said Kenneth A. 杰姆森,M.D., 指南作者, cardiologist and professor of cardiovascular medicine with the University of Michigan Health System. “Hypertension occurs at a younger age for African-Americans than for whites. 当达到140 / 90的时候, their prolonged exposure to elevated blood pressure has a potential for worse outcome.”

Heart disease also develops earlier in African-Americans and high blood pressure plays a role in more than 50 percent of all deaths from it. 非裔美国人的心脏病发病率更高, 心脏骤停, 心脏衰竭和中风比白人多. 另外，他们的风险是4.对于终末期肾脏疾病是2倍, which often progresses to the need for dialysis multiple times a week and ultimately to kidney transplantation or death.

“Hypertension has been a blight on the African-American community for many, many years. 现在是我们克服它的时候了。.他是芝加哥拉什大学医学中心心脏病学主任. “人们需要接受筛查和护理.”

The new guidelines are expected to offer new ways for medical providers to work with patients, 谁会被要求通过戒烟来改变他们的生活方式, 不饮酒或适量饮酒, 健康饮食, 经常锻炼.

“你可能不需要吃药，”贾默森说. “These discussions are more work for a provider, but it’s great for the patient. 他们被带进了这个过程.”

如果需要药物, the new directions are to treat earlier and more aggressively to get blood pressure into the normal range right off the bat.

“我们的数据显示控制早期作品，”贾默森说.

That’s different from the old-school way of prescribing one drug and slowly upping the dose or adding other meds if the patient doesn’t reach the target.

“We have struggled at every level,” Williams said about African-Americans’ high blood pressure. “确定谁拥有它, 一旦确定, 让他们得到治疗, 控制他们.”

The guidelines are also offering race-specific treatment recommendations by addressing drug efficacy in African-Americans. The guidelines point out that thiazide-type diuretics and/or calcium channel blockers are more effective in lowering blood pressure in African-Americans when given alone or at the beginning of multidrug regimens.

Jamerson said there is no downside to more aggressively treating high blood pressure from the start.

“If one takes the long view, then everyone should appreciate this approach,” he said. “治疗更多人的药物成本很低, 与中风的成本相比, 心血管疾病或心力衰竭. 这是显而易见的.”

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