ABCD of Hypertension Treatment in Different Ethnic Groups

According to the BMJ, hypertension (HTN) in Caucasians is high renin (type 1) HTN and responds best to treatment with ACEi and beta-blockers (AB drugs).

HTN in young black people is low renin (type 2) HTN and responds better to calcium channel blockers and diuretics (CD drugs).

Morris Brown writes that "as for diabetes, hypertension can usefully be considered as of type 1 or type 2, each with its own preferred treatment."

AB = ACEi, BB for type 1 HTN

CD = CCB, Diuretics for type 2 HTN

This is the proposed ABCD of HTN treatment.

A study published in the Jan 2008 edition of Archives of Internal Medicine "failed to provide support for the selection of alpha-blockers, ACEi, or CCB over thiazide-type diuretics to prevent cardiovascular problems in patients with metabolic syndrome."

References:

Hypertension and ethnic group. Morris J Brown. BMJ 2006;332:833-836 (8 April)
New Debate on Some Blood Pressure Drugs. WebMD Medical News, 01/2008.

Personalised medicine for hypertension - measuring renin could refine treatment of resistant HTN http://goo.gl/MmZhs

Image source: Wikipedia