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Hypertensive complications in blacks

Brent M Egan, MD
Section Editors
George L Bakris, MD
Norman M Kaplan, MD
Deputy Editor
John P Forman, MD, MSc


Hypertension in blacks as compared with whites tends to be more common, to present earlier in life, and to be more severe (figure 1) [1]. In addition, progression from prehypertension to hypertension is accelerated in blacks [2]. The reasons for these observations are incompletely understood, as the relative importance of environmental and genetic factors has not been established [3,4]. The treatment of hypertension is discussed separately. (See "Treatment of hypertension in blacks".)

Important risk factors for hypertension among blacks include:

Lower socioeconomic status

Ingestion of a high-sodium/low-potassium diet

Another possible mechanism, which is also related to lower socioeconomic class, is poor maternal nutrition leading to low birth weight in the infant. Low birth weight has been associated with an increased risk of hypertension in adulthood, perhaps due in part to impaired renal growth [5]. An associated reduction in renal development with fewer functioning nephrons may contribute to the predisposition to the development of end-stage renal disease (ESRD) [5], including ESRD occurring before the age of 50 years, in African Americans [6]. (See "Possible role of low birth weight in the pathogenesis of primary (essential) hypertension".)

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Literature review current through: Oct 2017. | This topic last updated: Dec 05, 2016.
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