What is the initial therapy for hypertension in black patients?

The initial therapy for hypertension in black patients is typically thiazide diuretics or calcium channel blockers. This recommendation is based on several studies, including clinical trials that have shown that black patients often respond better to these classes of medications when managing hypertension.

Thiazide diuretics help reduce blood pressure by promoting the excretion of sodium and water, thus decreasing blood volume. On the other hand, calcium channel blockers work by relaxing the vascular smooth muscle and decreasing peripheral vascular resistance, which is particularly effective in this population.

Other antihypertensive agents, such as ACE inhibitors and ARBs, are beneficial for many individuals but may show less efficacy in black patients as initial treatment options unless there are other comorbid conditions such as heart failure or chronic kidney disease. Beta-blockers, while useful for specific indications (like heart failure or post-myocardial infarction), are not typically used as first-line agents for hypertension as they may not be as effective compared to the preferred options in this demographic.

Overall, the choice of thiazides or calcium channel blockers as initial therapy for hypertension aligns with the evidence-based guidelines to optimize blood pressure control in black patients.