Management of High Blood Pressure in Blacks by John M. Flack, Domenic A. Sica, George Bakris, Angela L. Brown, Keith C. Ferdinand, Richard H. Grimm, W. Dallas Hall, Wendell E. Jones, David S. Kountz, Janice P. Lea, Samar Nasser, Shawna D. Nesbitt, Elijah Saunders, Margaret Scisney-Matlock, and Kenneth A. Jamerson Hypertension Volume 56(5):780-800 November 1, 2010 Copyright © American Heart Association, Inc. All rights reserved.

Figure 1. Risk stratification and treatment algorithm for blacks with hypertension. Figure 1. Risk stratification and treatment algorithm for blacks with hypertension. Aldo Antag indicates aldosterone antagonist; Tx, treatment. *Target organ damage is defined as albumin:creatinine ratio >200 mg/g, eGFR <60 mL/min per 1.73 m2, or electrocardiographic or echocardiographic evidence of LVH. †Indicators of preclinical CVD include metabolic syndrome, Framingham risk score >20%, prediabetes (impaired fasting glucose [100 to 125 mg/dL] and/or impaired glucose tolerance [2-hour postload glucose ≥140 mg/dL]) or diabetes mellitus. ‡CVD includes HF (systolic or diastolic), CHD/postmyocardial infarction, peripheral arterial disease, stroke, transient ischemic attack, and/or abdominal aortic aneurysm. §Most effective 2-drug combinations: CCB+RAS blocker; thiazide diuretic+RAS blocker; thiazide diuretic+aldosterone antagonist; and thiazide diuretic+β-blocker. Recommended RAS blockers are ACE inhibitors or ARBs in ACE inhibitor–intolerant patients.1 Preferred combination therapy in edematous and/or volume overload states. John M. Flack et al. Hypertension. 2010;56:780-800 Copyright © American Heart Association, Inc. All rights reserved.

Figure 2. Guide to multidrug antihypertensive therapy in blacks with hypertension. Figure 2. Guide to multidrug antihypertensive therapy in blacks with hypertension. Aldo indicates aldosterone; non-DHP, nondihydropyridine. John M. Flack et al. Hypertension. 2010;56:780-800 Copyright © American Heart Association, Inc. All rights reserved.