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● Based on evidence of higher propensity to vascular damage, target blood pressure values for Blacks have been lowered  by The International Society on Hypertension in Blacks: <130/80 mm Hg for patients with either target organ damage or cardiovascular disease and 135/85 for the remaining patients.
● When blood pressure is >15/10 mm Hg above target, two-drug therapy is recommended, with either a calcium channel blocker (typically amlodipine) plus a renin-angiotensin system blocker or, alternatively, in edematous and/or volume-overload states, with a thiazide diuretic plus a renin-angiotensin system blocker. Monotherapy with a diuretic or calcium channel blocker is preferred if blood pressure is ≤10 mm Hg above target levels. However, do not neglect to consider drug choice-relevant comorbidities and to establish antihypertensive effectiveness!
● Using the Framingham cardiovascular risk score, validated in Blacks, is recommended.
● Note that these recommendations may apply only to populations along the West African coast as they are based on studies mostly on US African-Americans.
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