Racial Differences in the Effectiveness of Nonpharmacologic Treatment of Hypertension

To the Editor:Hypertension is responsible for much morbidity and mortality,1 in particular cerebrovascular and cardiovascular disease. Intensive treatment of hypertension reduces the incidence of stroke and cardiovascular events and decreases cardiovascular mortality compared with less intensive blood pressure reduction.2 Antihypertensive drugs are efficacious in reducing blood pressure, but their use is associated with a variety of side effects,3 and adherence to medication is often poor. A nonpharmacologic approach is generally recommended in the initial treatment of mild hypertension or as an adjunct to pharmacologic therapy in patients with more severe or resistant hypertension. Several trials have shown favorable changes in blood pressure with diet modification, weight reduction, sodium restriction, and physical exercise.4,5 We wished to investigate possible racial differences in effectiveness …