Hypertension: racial differences.
Hypertension: racial differences.
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高血压：种族差异。
DOI：
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发表时间：
1990
期刊：
影响因子：
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通讯作者：
Eisner Gm
中科院分区：
文献类型：
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作者：
Eisner Gm
回顾了黑人和白人人群中高血压患病率、病程和病理生理学特征的种族差异。累积的流行病学数据表明，在几乎所有年龄和性别匹配的群体中，黑人高血压的患病率都高于白人。与白人相比，黑人高血压患者左心功能不全、中风和肾损害的发生率较高，但缺血性心脏病的发生率较低。黑人和白人之间一个显著的病理生理差异是盐敏感；正常血压和高血压的黑人往往对盐敏感。黑人的肾素水平也往往比白人低，而与白人相比，黑人对盐负荷的多巴胺反应减弱。这些差异和其他方面导致了这样的建议，即黑人的高血压最初应该通过限制食盐来控制；如果饮食控制不充分，建议服用一种24小时有效的降压药，这种药物可以降低血管外周阻力，促进钠排泄，并有可能改善肾脏血流动力学。钙通道阻滞剂可以满足这些要求。
Racial differences in the prevalence, course, and pathophysiologic characteristics of hypertension in black and white populations are reviewed. Accumulated epidemiologic data indicate that the prevalence of hypertension among blacks is greater than that among whites in almost all age- and sex-matched groups. Hypertensive blacks have a higher incidence of left ventricular dysfunction, stroke, and renal damage, but a lower incidence of ischemic heart disease, than do hypertensive whites. A significant pathophysiologic difference between blacks and whites is salt sensitivity; normotensive, as well as hypertensive, blacks tend to be salt sensitive. Blacks also tend to have lower renin levels than do whites, while dopamine response to a salt load is diminished among blacks as compared with whites. These differences and others lead to the recommendation that hypertension among blacks should be managed initially with salt restriction; if dietary control is insufficient, administration of an antihypertensive agent with 24-hour efficacy, which lowers vascular peripheral resistance, promotes sodium excretion, and potentially improves renal hemodynamics, is recommended. A calcium channel blocker may satisfy these requirements.