%0 Journal Article
%T Management of Hypertension in High-Risk Ethnic Minority with Heart Failure
%A M. Demede
%A A. Pandey
%A L. Innasimuthu
%A G. Jean-Louis
%A S. I. McFarlane
%A G. Ogedegbe
%J International Journal of Hypertension
%D 2011
%I Hindawi Publishing Corporation
%R 10.4061/2011/417594
%X Hypertension (HTN) is the most common co-morbidity in the world, and its sequelae, heart failure (HF) is one of most common causes of mortality and morbidity in the world. Current understanding of pathophysiology and management of HTN in HF is mainly based on studies, which have mainly included whites. Among racial groups, African-American adults have the highest rates ( ) of hypertension in the world and are more resistant to treatment. There is an emerging consensus on the significance of racial disparities in the pathophysiology and treatment options of hypertension and heart failure. However, African Americans had been underrepresented in all the trials until the initiation of the A-HEFT trial. Since the recognition of obstructive sleep apnea (OSA) as an important medical condition, large clinical trials have shown benefits of OSA treatment among patients with HTN and HF. This paper focuses on the pathophysiology, causes of secondary hypertension, and treatment of hypertension among African-American patients with heart failure. There is increasing need for randomized clinical trials testing innovative treatment options for African-American patients. 1. Introduction Hypertension (HTN) is the most common comorbidity in the world with significant public health implications [1, 2]. The overall U.S. prevalence of hypertension among adults ages ¡Ý18 years in 2005¨C2008 was 30.9% and was highest among persons ages ¡Ý65 years (69.7%) [3] and non-Hispanic blacks (44%) [4]. The American Heart Association estimates that the incurred costs of hypertension are more than $93.5£¿billion per year, and that cardiovascular disease and stroke for which HTN is the predominant risk factor, account for 17% of the total annual health expenditures in the United States [5]. Hypertension and its sequelae, heart failure (HF) [6], are a progressive disease. Evidence shows that less than half of patients with heart failure survive five years (after diagnosis), and less than a quarter of them live ten years after their initial diagnosis [7]. The incidence is about 550,000 each year in the United States. Framingham Heart Study showed that hypertensive patients were more likely to develop heart failure (142 cases of HF detected during the first 16 years of followup) than those who were normotensive [8]. The lifetime risk for development of HF among people with blood pressure (BP) >160/90£¿mm£¿Hg is double that of those with BP <140/90£¿mm£¿Hg. Heart failure in comparison to the most prevalent gender malignancies (bowel cancer in men and breast cancer in women), was associated with worse
%U http://www.hindawi.com/journals/ijhy/2011/417594/