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Cohort study
ACE inhibitors in African Americans with hypertension associated with worse outcomes as compared to other antihypertensives
  1. Lars H Lund1,2
  1. 1Department of Medicine, Unit of Cardiology, Karolinska Institutet, Stockholm, Sweden;
  2. 2Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
  1. Correspondence to : Dr Lars H Lund, Department of Medicine, Unit of Cardiology, Karolinska Institutet, N305, Stockholm 17176, Sweden; Lars.Lund{at}alumni.duke.edu

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Hypertension affects one-third of the world's population and remains a leading cause of myocardial infarction, stroke, heart failure, renal failure and death. Although hypertension control has improved,1 the prevalence is increasing due to an ageing population, rising obesity and a shift towards western lifestyles and disease patterns in low-income and middle-income countries. Hypertension is now also a major contributor to heart failure in low-income countries.2 Furthermore, control of blood pressure (<140/90 mm Hg) is achieved in only half of patients.1 In the recent landmark Systolic Blood Pressure Intervention Trial (SPRINT) a systolic blood pressure target of 120 vs 140 mm Hg led to a considerable reduction in cardiovascular outcomes and death.3 Therefore, a pressing worldwide concern is how to obtain adequate blood pressure control. This is especially …

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