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World J Cardiol. Sep 26, 2014; 6(9): 878-889
Published online Sep 26, 2014. doi: 10.4330/wjc.v6.i9.878
Published online Sep 26, 2014. doi: 10.4330/wjc.v6.i9.878
African Americans, hypertension and the renin angiotensin system
Sandra F Williams, Department of Endocrinology, Cleveland Clinic, Weston, FL 33331, United States
Sandra F Williams, Department of Clinical Biomedical Science, Charles E Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, United States
Susanne B Nicholas, Division of Nephrology and Division of Endocrinology, Diabetes and Hypertension, Department of Medicine David Geffen School of Medicine, University of California, Los Angeles, CA 94305, United States
Nosratola D Vaziri, Division of Nephrology and Hypertension, Departments of Medicine, Physiology and Biophysics, University of California, Los Angeles, CA 94305, United States
Keith C Norris, Division of General Internal Medicine and Health Services Research, Los Angeles, CA 90024, United States
Keith C Norris, Department of Medicine David Geffen School of Medicine, University of California, Los Angeles, CA 90024, United States
Author contributions: All authors contributed to this work.
Supported by UL1TR000124, P30AG021684, P20-MD000182 and DK065455, National Institutes of Health
Correspondence to: Keith C Norris, MD, FASN, Professor of Medicine, Division of General Internal Medicine and Health Services Research, 911 Broxton Ave, Room 103, Los Angeles, CA 90024, United States. kcnorris@mednet.ucla.edu
Telephone: +1-310-7946973 Fax: +1-310-7940732
Received: January 24, 2014
Revised: June 28, 2014
Accepted: July 15, 2014
Published online: September 26, 2014
Processing time: 246 Days and 15.7 Hours
Revised: June 28, 2014
Accepted: July 15, 2014
Published online: September 26, 2014
Processing time: 246 Days and 15.7 Hours
Core Tip
Core tip: African Americans have exceptionally high rates of hypertension and hypertension related complications. Due to a greater likelihood of having a low plasma renin levels, inhibitors of the renin angiotensin system (RAS) are often not recommended as initial antihypertensive therapy. However, animal models suggest hypertension characterized by low circulating renin levels have a paradoxical increase in tissue RAS activity. Thus treatment with RAS inhibitors may be critical to preventing end organ damage. We describe the rationale of RAS blockade as part of a comprehensive approach to attenuate the high rates of premature morbidity and mortality associated with hypertension among African Americans.