Hypertension , diabetes and stroke in Afro - Caribbeans

Hypertension is more common in Afro-Caribbeans than caucasian population in the UK.

• monotherapy for hypertension - low dose diuretic or calcium channel blocker
  • Afro-caribbeans tend to develop low-renin, salt sensitive type hypertension. Monotherapy for hypertension with beta-blockers or ACE - inhibitors is less effective than low dose diuretics or a calcium channel blockers (1,3,4)
    
    
• when a diuretic or a calcium channel blocker is used in combination with an ACE inhibitor of beta blocker, the treatment may be as efffective as in the general population (3). However a combination of a diuretic, a calcium channel blocker and an ACE inhibitor may be required (3)

Coronary artery disease occurs at only half to two-thirds of the national level. More Afro-Caribbean people die from stroke, heart failure and renal pathology secondary to hypertension.

Type 2 diabetes is more common in hypertensive Afro-Caribbeans.

Reference:

1. Factfile (9/97). British Heart Foundation
2. Marmot (1992). Primary prevention of stroke. Lancet 339.
3. Drug and Therapeutics Bulletin (2001), 39(5), 37-40.
4. NICE (August 2011). Hypertension - management of hypertension in adults in primary care.