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Contemporary and Future Concepts on Hypertension in African Americans: COVID-19 and Beyond.
Ferdinand, Keith; Batieste, Tivona; Fleurestil, Mashli.
  • Ferdinand K; Gerald S. Berenson Endowed Chair in Preventive Cardiology, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: kferdina@tulane.edu.
  • Batieste T; Tulane University School of Medicine, New Orleans, LA, USA.
  • Fleurestil M; Tulane University School of Medicine, New Orleans, LA, USA.
J Natl Med Assoc ; 112(3): 315-323, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-603628
Semantic information from SemMedBD (by NLM)
1. Hypertensive disease PROCESS_OF African American
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
African American
2. Cardiovascular Diseases CAUSES Cessation of life
Subject
Cardiovascular Diseases
Predicate
CAUSES
Object
Cessation of life
3. Hypertensive disease AFFECTS African American
Subject
Hypertensive disease
Predicate
AFFECTS
Object
African American
4. inhibitors TREATS Resistant hypertensive disorder
Subject
inhibitors
Predicate
TREATS
Object
Resistant hypertensive disorder
5. Crisis PROCESS_OF African American
Subject
Crisis
Predicate
PROCESS_OF
Object
African American
6. Hypertensive disease PROCESS_OF African American
Subject
Hypertensive disease
Predicate
PROCESS_OF
Object
African American
7. Cardiovascular Diseases CAUSES Cessation of life
Subject
Cardiovascular Diseases
Predicate
CAUSES
Object
Cessation of life
8. Hypertensive disease AFFECTS African American
Subject
Hypertensive disease
Predicate
AFFECTS
Object
African American
9. inhibitors TREATS Resistant hypertensive disorder
Subject
inhibitors
Predicate
TREATS
Object
Resistant hypertensive disorder
10. Crisis PROCESS_OF African American
Subject
Crisis
Predicate
PROCESS_OF
Object
African American
ABSTRACT

BACKGROUND:

Cardiovascular disease related mortality is the leading cause of death in the United States, with hypertension being the most prevalent and potent risk factor. For decades hypertension has disproportionately affected African Americans, who also have a higher burden of associated comorbidities including diabetes and heart failure.

METHODS:

Current literature including guideline reports and newer studies on hypertension in African Americans in PubMed were reviewed. We also reviewed newer publications on the relationship between COVID-19 and cardiovascular disease.

FINDINGS:

While APOL1 has been theorized in the epidemiology of hypertension, the increased prevalence and associated risks are primarily due to environmental and lifestyle factors. These factors include poor diet, adverse lifestyle, and social determinants. Hypertension control can be achieved by lifestyle modifications such as low sodium diet, weight loss, and adequate physical activity. When lifestyle modifications alone do not adequately control hypertension, a common occurrence among African Americans who suffer with greater prevalence of resistant hypertension, pharmacological intervention is indicated. The efficacy of renal denervation, and the use of sodium-glucose cotransporter 2 and aminopeptidase A inhibitors, have been studied for treatment of resistant hypertension. Furthermore, the recent COVID-19 crisis has been particularly devastating among African Americans who demonstrate increased incidence and poorer health outcomes related to the disease.

CONCLUSION:

The disparities in outcomes, which are largely attributable to a greater prevalence of comorbidities such as hypertension and obesity, in addition to adverse environmental and socioeconomic factors, highlight the necessity of specialized clinical approaches and programs for African Americans to address longstanding barriers to equitable care.
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Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / African Americans / Cardiovascular Diseases / Coronavirus Infections / Vulnerable Populations / Healthcare Disparities / Hypertension Type of study: Diagnostic study / Clinical Practice Guide / Prevalence study / Randomized controlled trials / Reviews / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Natl Med Assoc Year: 2020 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / African Americans / Cardiovascular Diseases / Coronavirus Infections / Vulnerable Populations / Healthcare Disparities / Hypertension Type of study: Diagnostic study / Clinical Practice Guide / Prevalence study / Randomized controlled trials / Reviews / Risk factors Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Natl Med Assoc Year: 2020 Document Type: Article