Ethnicity and Ambulatory Blood Pressure Measurement: Relationship to Clinic and Laboratory Measurements

African Americans have a higher prevalence of hypertension than white Americans. Morbid consequences of hypertensive disease are greater in blacks than whites. For members of high‐risk groups such as blacks, ambulatory blood pressure monitoring may be useful in supplementing casual clinic measurements to prevent misdiagnosis, better characterize the temporal topography of blood pressure responses, and improve prediction of left ventricular hypertrophy, hypertensive complications, morbidity, and mortality. In conjunction with other data, laboratory experiments showing that African Americans as a group show greater peripheral resistance and slowed natriuretic responses to behavioral stressors than whites, appear to provide insights as to why blacks generally respond better to diuretics and calcium channel blockers than to β‐adrenergic antagonists or angiotensin‐converting enzyme inhibitors. It is suggested that ambulatory blood pressure monitoring and behavioral tasks in the laboratory may help predict individual responsiveness to antihypertensive agents.