Blood Pressure and Ethnicity: the Link that Determines Treatment
Have you ever wondered why your provider prescribes a specific medication for your
hypertension? Have you ever wondered how effective it is? Or why is it a certain medication that works better for yourself or another person? Well studies have revealed an important connection between hypertension treatment and ethnicity that changes how individuals should be treated.
What is Hypertension?
As described by the Cleveland Clinic, hypertension is a common condition that affects the
body’s arteries, simply referred to as high blood pressure, and if left untreated can force the heart to work harder resulting in increased risk of a heart attack (1). Hypertension is a leading cause of heart disease and occurs when blood pressure is high, resulting in greater levels of force on the arterial walls which push the heart to work harder. Normally blood pressure is below 120/80 mmHg (millimeters of mercury) with the top number being the systolic pressure or contraction pressure and the bottom number being the diastolic or relaxation pressure (1). Stage 1 hypertension is defined with a systolic pressure range of 130-139 mmHg or diastolic range of 80-89 mmHg. Meanwhile, stage 2 hypertension has a systolic pressure greater than 140 mmHg and diastolic pressure greater than 90 mmHg (1). Hypertension can often be treated through lifestyle modifications such as changing diet and participating in exercise. Diet is one of the leading causes of chronic hypertension from high salt intake, low potassium intake, high saturated fats from red meats, full fat diary, palm oils, can all increase blood pressure (1,2). When high blood pressure is caused by no discernable cause and is a primarily lifestyle issue, it is called primary hypertension (1). In comparison, high blood pressure from a discernable cause such as organ failure or chronic conditions is called secondary hypertension (1). Depending on how long the hypertension lasts and whether lifestyle changes are successful in lowering blood pressure, a provider might need to begin prescribing hypertension medications. Here is where treatment can
vary based on ethnicity, as more recent studies have determined that different races may respond best to certain medications.
Hypertension Treatment: Medications
The types of hypertension medications vary by what they actually do in the body. Some common classes are:
1. Diuretics: which help flush out excess salt and water (3).
2. Beta-blockers: lower heart rate and can relax arteries (3).
3. Angiotensin-converting enzyme (ACE) inhibitors: which stops an enzyme known as
angiotensin from increasing blood pressure (3).
4. Calcium channel blockers: which prevents calcium from entering the heart’s muscle
and arteries which helps them relax and open blood vessels (3).
Each of these performs different functions and can vary in effectiveness depending on the
patient. An article from the Imperial College in London collected multiple clinical studies and
found that for African Americans, a beta blocker atenolol proved less effective than for White
patients (4). Meanwhile with a perindopril (ACE inhibitor) and amlodipine (calcium channel
blocker) combined therapy proved heavily effective for Asians, effective for Whites, and while
amlodipine was working for African Americans, perindopril was not as successful in lowering
blood pressure (4).
The Ethnic Difference
The study by the Imperial college showed something incredibly important: there is no such thing as perfect medicine. Every individual is different and because of many factors, treatment of hypertension and its effectiveness can change by race. That is why more research is being done on patient-provider relationships and advancing precision medicine. Precision medicine being an area of medicine focusing on connecting individual factors such as social, economic, ethnic, and biological backgrounds to deciding on the most appropriate treatment plan. What the article from the Imperial College reveals is that a more individualized view of hypertension is important in planning accurate treatment. As seen, common medicative treatment of hypertension varied in effectiveness with race with multiple of the prescribed therapies such as amlodipine and perindopril being commonplace. The effectiveness of each regimen and their differences is important to account for your management of blood pressure. Remembering how your background can determine your treatment is important in advocating yourself and getting the best treatment possible.
References
1. High Blood Pressure (Hypertension) Cleveland Clinic.
(accessed 11 July2026).
2. The best and worst foods for high blood pressure. British Heart Foundation.
that-lower-blood-pressure (accessed 11 July2026)
3. Types of Blood Pressure Medications. www.heart.org. https://www.heart.org/en/health-
topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/types-
of-blood-pressure-medications (accessed 11 July2026).
4. Gupta AK. Racial Differences in Response to Antihypertensive Therapy: Does One Size
Fits All? Int J Prev Med 2010; 1: 217–219.
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