New Black American High Blood Pressure Guidelines

The American Medical Association has issued new blood pressure guidelines through it’s Joint National Committee 1 (JNC). The eighth edition (JNC 8) has important information for Black Americans since over forty percent of Black Americans have high blood pressure2 according to Centers for Disease Control and Prevention (CDC). High blood pressure is one the major contributing factors3 (CDC) in the deaths of African Americans. High blood pressure can lead to strokes4 (CDC) and heart attacks5 (National Institutes Of Health), two of the leading causes of reduced quality of life, and death.

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The new guidelines emphasize control of high blood pressure with age and comorbidity-specific treatment cutoffs. A comorbidity is a disease existing simultaneously with, and usually independently of, another medical condition. For example, someone can have hypertension (high blood pressure) and not have diabetes. But, on the other hand, someone with diabetes very often has hypertension too.

Jay Harold will focus on the patients of African descent. The changes in JNC 8 are crucial since many Black Americans did not know or follow the previous guidelines.

Drugs Used to Reduce High Blood Pressure in African-Americans

We will give a brief and simplified description of the four different classes of medications recommended for use by Black Americans. Remember to consult your doctor or pharmacist for more detailed information.

New Black American High Blood Pressure Guidelines

High blood pressure is one the major contributing factors in the deaths of Black Americans.


Diuretics are among the most commonly used drugs. They act by reducing sodium (salt) reabsorption at different sites in the nephron (kidney), thereby increasing urinary (urine) sodium and water losses. The ability to cause loss of fluids in the body has made diuretics useful in the treatment of a variety of conditions, particularly excess fluid (swelling) states and hypertension.

Thiazide-type diuretics act on the distal tubule6 of the kidney and appear to be effective for people of African descent per Recommendation 7 of JNC 87. It is partly responsible for the regulation of potassium, sodium and calcium. Examples of thiazide diuretics include hydrochlorothiazide, chlorthalidone, indapamide, and metolazone. Thiazide diuretics have some side effects, including impotence and electrolyte changes. Talk to your doctor to choose the drugs within this class that minimizes these side effects.

Calcium Channel Blockers

Recommendation 7 of JNC 8 also applies to Calcium Channel Blockers (CCBs).  Calcium channel blockers8 (CCBs) prevent calcium from entering cells of the heart and blood vessel walls, resulting in lower blood pressure. Calcium channel blockers relax and widen blood vessels by affecting the muscle cells in the arterial walls. Some CCBs have the added benefit of slowing your heart rate, which can further reduce blood pressure, relieve chest pain (angina) and control an irregular heartbeat. Medications representative of this class includes amlodipine, diltiazem, nifedipine and verapamil. Side effects include dizziness, headache, and constipation.

Angiotensin Converting Enzyme Inhibitors

Angiotensin-converting enzyme inhibitors9 (ACEIs) are used to treat heart disease. These medicines make your heart work less hard by lowering your blood pressure. This keeps some kinds of heart disease from getting worse. Most people who have heart failure take these medicines.

These medicines treat high blood pressure, strokes, or heart attacks. They are also used to treat diabetes and kidney problems. Enalapril, (Vasotec), lisinopril (Zestril), and ramipril (Altace). Side effects exhibited include a cough, dizziness, and high potassium levels.

 Angiotensin II Receptor Blockers

 Angiotensin II Receptor Blockers10 (ARBs) inhibit a substance that causes blood vessels to narrow (constrict). As a result, blood vessels relax and widen (dilate), making it easier for blood to flow through the vessels, which reduces blood pressure. These medicines also increase the release of water and salt (sodium) to the urine, which in turn lowers blood pressure as well. Preventing the blood vessels from constricting helps improve blood flow, which reduces the backup of blood in the heart and lungs. It also decreases the pressure that the left ventricle of the heart must pump against. Angiotensin II receptor blockers also act directly on the hormones that regulate sodium and water balance. Side effects can include dizziness, sinus problems and stomach problems. Commonly prescribed medications in this class are losartan (Cozaar), valsartan (Diovan) and olmesartan (Benicar).

Best High Blood Pressure Drug Choices for Black Americans

Jay Harold has to get into more detail now because you need to know what studies were used to draw these conclusions.

Michael Page’s In-Depth Guide on JNC 811 states that ACEIs and ARBs may not be an ideal choice in patients of African descent. Results of a subgroup analysis in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) found that ACEIs led to worse cardiovascular outcomes than thiazide-type diuretics or CCBs in patients with African ancestry.

Despite the subgroup analysis of ALLHAT, results of the African American Study of Kidney Disease and Hypertension (AASK) support the use of first-line or add-on ACEIs to improve kidney-related outcomes in patients of African descent with hypertension, chronic kidney disease, and proteinuria. Proteinuria is a condition in which urine contains an abnormal amount of protein. As a result, the JNC 8 panelists recommend that all patients with chronic kidney disease and hypertension, regardless of ethnic background, should receive treatment with an ACEI or ARB to protect kidney function, either as initial therapy or add-on therapy.

One exception to the use of ACEIs or ARBs in the protection of kidney function applies to patients over the age of 75. The panel cited the potential for ACEIs and ARBs to increase serum creatinine and produce hyperkalemia (high potassium level in blood). As a result, for patients over the age of 75 with decreased renal function, thiazide-type diuretics or CCBs are an acceptable alternative to ACEIs or ARBs. Also, the panel expressly prohibits the simultaneous use of an ACEI and an ARB in the same patient. This combination has not been shown to improve outcomes.

When Will The Meds Start Working?

New Black American High Blood Pressure Guidelines

Your Blood Pressure should be lower within one month of starting treatment.

The JNC 8 guideline authors simplified a complicated recommendation for follow-up in patients with hypertension.

The JNC 7 panel recommended that after an initial high blood pressure reading, follow-up with a confirmatory blood pressure reading should occur within 7 days to 2 months, depending on how high the first reading was and whether or not the patient had kidney disease or end-organ damage as a result of hypertension.

Under JNC 8, in all cases, goal blood pressure targets should be reached within a month of starting treatment either by increasing the dose of the initial drug or by using a combination of medications. This is Recommendation 9 of the JNC 8 report.

Ways to Reduce High Blood Pressure without Drugs

The National Institutes of Health offers ways to prevent the long-term problems High Blood Pressure causes. Healthy lifestyle habits can help you maintain normal blood pressure.

  • Follow a healthy diet. Limit the amount of sodium (salt) and alcohol that you consume. The National Heart, Lung, and Blood Institute’s DASH (Dietary Approaches to Stop Hypertension) eating plan12 promote healthy eating.
  • Be physically active. Routine physical activity can lower high blood pressure (HBP) and reduce your risk for other health problems.
  • Maintain a healthy weight. Staying at a healthy weight can help you control HBP and reduce your risk for other health issues.
  • Quit smoking. Smoking can damage your blood vessels and raise your risk for HBP. Smoking also can worsen health problems related to HBP.
  • Learn to manage and cope with stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.
    New African-American High Blood Pressure Guidelines

    Healthy lifestyle habits can help you maintain normal blood pressure.

Many people who adopt these healthy lifestyle habits can prevent or delay HBP. The more lifestyle changes you make, the more likely you are to lower your blood pressure and avoid related health problems. For more information about healthy lifestyle habits, go to “How Is High Blood Pressure Treated13?”

Jay Harold has a handy medication guide on High Blood Pressure for Black Americans.  Learn more by reviewing “African American Med Guide for High Blood Pressure.”

Click this link to get free Health and Wealth information to improve  your life. Take a car ride through recent Civil Rights History with  free  “Slow Roll Through Civil Rights” on the Jay Harold website. Enjoyed this post?  Share it and read more here.

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    • Jay Fulce


      Thank you for your question, Denise. This is what the Centers of Disease Control (CDC) says about High Blood Pressure:

      What Blood Pressure Numbers Mean

      Blood pressure is measured using two numbers. The first number, called systolic blood pressure, represents the pressure in your blood vessels when your heart beats. The second number, called diastolic blood pressure, represents the pressure in your blood vessels when your heart rests between beats. Blood pressure is measured in millimeters of mercury (mmHg).

      The chart below shows normal, at-risk, and high blood pressure levels. A blood pressure less than 120/80 mmHg is normal. A blood pressure of 140/90 mmHg or more is too high. People with levels from 120/80 mmHg to 139/89 mmHg have a condition called prehypertension, which means they are at high risk for high blood pressure.

      Blood Pressure Levels


      systolic: less than 120 mmHg
      diastolic: less than 80mmHg

      At risk (prehypertension)

      systolic: 120–139 mmHg
      diastolic: 80–89 mmHg


      systolic: 140 mmHg or higher
      diastolic: 90 mmHg or higher

      I hope this answers your question.

      Jay Harold

  1. Ralph Hanshaw

    Am on a lot of medication foree hp. I was taken off aldampine witch I been on for over 20yrs because it was said it cause me to suffer with eczema for 20yrs . Once they took me off the aldampine my blood pressure went out of control 240/110 was hospitize for 3 -4 days now on a lot of new medication. Have not adjusted well yet. Had hp for 40yrs

    • Jay Fulce


      I’m sorry for the severe health issues you are having, Ralph. You should talk to your doctor about this situation and get some answers. You may want a second opinion if the answers are unsatisfactory.

      Your healthcare situation demands immediate help. Jay Harold provides general information and doesn’t give specific advice.

  2. jacqueline

    Lots of times people, especially African Americans are diagnosed with high blood pressure w/o being checked over a period of time. We have a lot of allergies to food, chemical, medication and trees. If you are having an allergic reaction your blood pressure will go up! I have been in Er a few times having an allergic reaction and the doctor say your pressure is high and I need to treat your HBP. I told them it’s because I ate something I’m allergic to. I allowed 1 doctor to give me a pillow and told her it will not affect my HBP. A hour later the doctor came back and told me I was right and apologized. We should become aware of what you are allergic to and try to stay away from it. In my case I have many.

    • Jay Fulce


      Very good point, Jacqueline. One of the first questions a healthcare professional should ask is about and other drug allergies.

  3. Yea I fine amloldepine or Calcium Channel blockers very important … I think normally the calsium channel is open and at the base of the channel there is a magnesium Ion , which is great when you want to relax but when you want to tense up, calcium goes into your cells thru the channel displacing the mg ion, causing your cell to contract strongly … So the calcium channel blocker literarl twist the channel so nothing can go in and out and the magnesium Ion is left to domnate and not be contested by calcium … If I don’t get my Calciuim channnel blocker I can goto 220/120 , and I have relatives who can go even higher … so I think diet, lifestyle, stress management including vigorous exercise at least 4x’s a week and meditation of not less than a half an hour a day very very important … I know also I can get off meds if I go w/ a pure raw diet , but I love cooked foods too much .

  4. Jason

    GREAT piece! I truly appreciate the break down between the different types of medications and how they achieve lowering HBP. It would’ve been nice to include the effects of drug and alcohol interactions + these drugs have on the body as well. I don’t know the level of difficulty involved in order to make that happen, but it was very-very informative nonetheless. Thank you!

    • Jay Fulce


      Thanks, Jason for your comments. I will post an article about drug and alcohol interactions at a future data. I just post an article named “Hardwood Floors”, that I feel you will enjoy.

      Jay Harold

  5. Tina M.

    I have this issue it seems only when I go to the doctors office, when they check me at home My readings are 127/131 over 78 or 82, but when I do go to the doctors office it is always 140/148 over 85. why is this? I don’t smoke or drink and I try to stay on my feet as much as possible and work out a few times a week or more. I have a blood pressure wrap at home like the doctor and I keep tabs on it and it is always lower at home, plus I have lost some weight. How do I get my reading down under 140 by the time I get to the doctors office? What is the issue here, any ideas. No I am not on any meds as well. I do not want to start that slow decent into pills. I am 56 and of African decent. Thank you.

  6. Chuck Williams

    OK, Just took my BP for the first time in about 7 months. It’s reading is 130/78. Where does that put me ?

  7. E.R.

    I’m a 50y/o bm have had 2 heart attacks and a stroke in a 5 year period a light smoker, don’t drink healthyish eater limited exercise. Taking atenolol/chorthal, atorvastatin, lisinopril,amlodipine besylate, low dose aspirin and also metformin for type 2 diabetes. To me it seems like I’m on to many meds for hbp and I know my bp is down. Is there a area of time this many hbp meds should be used or discontinued, or is it a life long treatment.

    • Jay Fulce


      E.R., I don’t comment on care for a specific person. That being said, some of the medications you listed have indications other than high blood pressure. Atorvastain is used to lower your cholesterol, while lisinopril can be used in heart failure and high blood pressure control. In fact, the medications you listed above could work well in a patient with high blood pressure, diabetes type 2 and has had a heart attack.

      E.R., you may need more detailed information about the objectives and treatment plan from your healthcare professional. Communication with your healthcare professional is very important. Read the post “Talking to Doctor Presents Challenges for African Americans“, for some ways to improve the flow of information.

  8. Lisa

    I don’t trust these people that are prescribing theses meds to keep their no’s up! My husband was rushed to the hospital 6mo’s ago! With a pressure of 220/185 out of no where. Here was delirious, and lost that whole day! He was admitted and told, Hydro Encephalopathy, to which all the mess they prescribed, did not and has not subsided any of the initial signs and symptoms he continues to have to this day. He is a 56 yo BM, with no health issues until now. 6.5ft was @275lbs now down to 255lbs. Has not been able to return to work, because they’re saying he has positional vertigo! WTH DOES THIS HAVE TO DO WITH HYPERTENSION?!!!! As he came out of the stupor that evening he was complaining of swirling sensation atop his has, (this was immediate) before even being processed to be admitted. Initial call to 911 happened @11:15 am. Other symptoms include tenederness at the cerebellum numbness left side of hands and feet, tightening sensations of chest, and a weird sensation at the start of these signs and symptoms,sometimes, often than not around med time! for 6mos. Stopped taking Hydochlorithyricide and aspirin. Now taking Metoprolol and Valium????!!!!… Pressure is normal. When high its at prehypertensive levels. For ten days has been put in lexapro! Frustrated, and I’m not the pt. imagine his position. In my opinion, he DOES NOT exhibit any HBP signs and symptoms, and when questioned, we’re immediately told, “he needs the meds to regulate the HBP! He has been to every dept, cardiology, MRI, neurology, ENT, PT, etc…

    • Jay Fulce


      I’m sorry for the numerous problems your husband have encountered. Jay Harold also have experienced very difficult situations caring for loved ones like you have described! That is the primary reason Jay Harold writes this blog. Jay Harold is not associated with anyone and strives to provide useful medical information. This allows people to make more informed decisions.

      There appears to be a serious communication problem between your family and the medical professionals. Subjective (Chief Complaint), Objective data, Assessment of your husband and a Plan of action should be clearly understood by you. I would continue to seek information from your providers and seek other medical opinions.

      Your love and caring for your husband is apparent. I wish everyone had someone like you on their side.

      Jay Harold

    • Jay Fulce


      Vonda, always talk to your doctor about the treatment plan that’s right for you. Toprol Xl (metoprolol) extended release is a medication that can be used in the treatment of several medical conditions. It can be used to treat chest pain (angina), heart failure, high blood pressure, Atrial Fibrillation/flutter and more. It’s in a class of drugs named beta blockers. The Beta Blockers usually are not the first choice to control high blood pressure in African Americans, but consult with your doctor.

      Toprol XL could be used to treat high blood pressure, Vonda. Jay Harold hopes he answered your question. Jay Harold is always looking for ways to improve your health.

  9. Debbie

    Thank you so much for all the information and insight you’ve given. I was diagnosed with HP in 1995 which I really didn’t want to believe & address the issue but sooner than later I did thanks to God & maturing I realized this was my life & future that was at stake because I initially believed the doctor was misdiagnosing me. Both of my parents suffered with HP. Needless to say my pressure is fine with low doses of linsinipril & nisoldipine along with weight loss & exercise it is very well controlled in 2015…along with less stress & retirement & of course God I’m okay. I will post & pass this information from you to. Others because it is so true…Thank you so much.

  10. I had a complete hysterectomy at the age of 19. I am now 67. I have high blood pressure no matter what I do it’s uncontrollable without meds. could this be because of my hysterectomy at such a young age? no ovaries, no uterus no to all gone.

    • Jay Fulce


      I’m sorry about your situation with the High Blood Pressure, Susan. Only your doctor(s) can answer your question(s) since they know you. Jay Harold has a post about what questions to ask your doctor before, during and after an office visit. The post is ” 5 Questions to ask your Doctor: And More.” The link is

      I hope this information leads to a good dialogue with your doctor and you find the answer to the question.

      Jay Harold

  11. I have hbp since i was 25yrs old. Been on losinipril, cozaar,avapro/150 mg 2×a day then 300mg once aday. Had angina 2008. Put on asa. 2010 had Myocardial infarction. (Mild)no dmg. Potassium,asa,losartan w/potassium.amolopine,chlorthalidone,and cholesterol. Which is high. Heart murmur.born with. Yes i have lost wht. I feel good. But lft leg swells everyday. Toresemide/don’t like it.mks me go to the bthrm too much. For over 20 yrs dr cld not control it. Now i have cardio/dr wrks well with my internist.

    • Jay Fulce


      Continue to work with your doctors, Ann. Only your doctor can give you specific medical advice. Water Pills such as Toresemide dosage are often reduced or another water pill (diuretic) medication is used. You are taking an active role in your health, which is essential. Jay Harold hopes this reply was helpful to you, Ann.

    • Jay Fulce


      Consumer Reports gives a very good description of Beta- Blockers. Beta-blockers are a group of drugs that are used to treat high blood pressure. They are also used to treat chest pain (angina), abnormal heart rhythm (arrhythmia), blocked arteries in the heart (coronary arteries), and heart failure (a condition when the heart muscle gets weaker and cannot pump blood as well). Learn more at

      Always consult your doctor if you have any questions about this class of medications. They do have potentially significant side effects. Jay Harold hopes he answered you the question, Ann.

  12. Andre Robertson

    I am a 54 yo AA male. I have worked out all of my adult life 40+ years. I have had hypertension for 10 years now. When I workout regularly my BP is usually 130/90. If I don’t workout my BP is 117/72. I take Losartan and Amlodopine. What is up with that?

    • Jay Fulce


      When do you take your blood pressure measurements, Andre? Your blood pressure readings could be higher after working out. Talk to your doctor about this and an adjustment in the time that your blood pressure measurements are taken may be needed. You have excellent blood pressure control the rest of the day. Keep up the good work!

  13. tambe

    To join in with more current information, my doctor and I have been reworking my medication to see why my BP was normal when I was on hydrochlorathorazide and the switch to Accupril was not effective.

    We are trying a new regime based on a medical conference she attended 6 months ago–in the medical community it was presumed that humans are “Night Dippers”–our pressure drops during the night, so we take our BP meds in the morning. They have now acknowledged that for some of us, this pressure drop does not occur. We are proactively moving my HBP med to the evening, as I am not dropping below 150. Looking forward to tracking the effects of the switch.

    Also–some of us in the African American community have a high resistance to absorbing BP meds. The body only absorbs a percentage of BP medication, so when you are prescribed a higher dosage, it is an attempt to get the body to absorb a higher percentage of the med.

    Thank you for sharing this information Jay Harold, it was very informative.

  14. Roy

    I’m 62 and I am using the Cammander Flex, it’s a home monitoring systems. I’m using it because I have the white coat syndrome.
    According to the machine it states for my age my readings should be under 150/90.
    My readings are 132/82. I also use a Life Source Monitor, which I use daily, right after using CF monitor. The number are points lower, e.g., 127/ 80. What’s up with that?
    And is that correct that my reading should be under 150/90 for my age. I’m not diabetic
    either or taking meds.


    • Jay Fulce


      Thanks for the question, Roy. The differences in the blood pressure readings between the two machines are insignificant.You are doing an excellent job of monitoring your blood pressure and getting good, consistent results.

  15. Brenda

    I’m not sure how to take my meds is it OK to take two at a time I know the the doctor wants me to take my atenenol at night but its self the other two meds I take are losartan, 100mg and Amlodipine .

    • Jay Fulce


      Thanks for your question, Brenda. There are no known interactions between atenolol, losartan and amlodipine. All three medications reduce your blood pressure by different methods of action. Is your blood pressure under control?

  16. denise

    I was reading some of the following comments below and noticed that in most of the reply’s JayHarold is refered to in third person. Is he or the “corporation not speakingfor themselves? It just seemed a little odd to me that people were pouring out their concerns about health and other situations and the replys seem so detached.

    • Jay Fulce


      Speaking in the third person doesn’t mean that Jay Harold is detached from the concerns of people. Jay Harold has a vested interest in improving the health of black people. Serving and giving back to the community in a way of life to Jay Harold. Jay Harold’s daddy was a County official in Miller County, Arkansas and always talked about giving something back to the people who gave him so much. Jay Harold grew up in an all black neighborhood in Texarkana, Arkansas and graduated from a black college (University of Arkansas- Pine Bluff). Jay Harold was elected his senior class Vice President and assumed the role of President when the President resigned early in his term. After graduating from pharmacy school (University of Missouri- Kansas City), Jay Harold decided to give back to the community as a pharmacist.

      Do you want me to tell you that I have paid for prescriptions when someone was short? I have. Do you want me to tell you about the young lady the same age of my daughter who just found out that she had herpes and I talked to her over 3 hours at the pharmacy? I followed up with her for months and prayed that I helped her in some way. Do you want me to tell you that I used to visit schools and talk about the dangers of drugs?

      Do you want me to tell you that I work a full time job and pay for this website and Facebook Page out of my pocket? Jay Harold Fulce has made a decision to help people. If one person has been helped, the time and effort was worth it.

      Here’s your answer to the third person question. When people talk about their health issues, they are in an emotional state. Family and friends sometimes make the situation worse. They want someone to give them the information they need without causing a panic. That’s why Jay Harold talks in the third person.

  17. Hi Jay. I had to chuckle when I read Denise’s post. I have to agree with her re how you use the moniker “Jay Harold”…it *is* a little odd…especially coupled with the grammatical errors in your posts. But…I also have to say your article/blog caught my eye on Facebook and I scanned it quickly, intending to read the entire article when I had time. Then I lost your article. The info you shared was so important to me I searched for your article to no avail. Then I happened to stumble on it tonight. So glad I did. You impart very important info for everyone, but especially for those of us who are African American. Thank you for sharing this information, however you choose to share it.

    My story: an old Asian doctor first told me I had HBP when I was just 32 years old. I’m 67 now. I was first prescribed a diuretic, later verapamil was added. I was diagnosed with a triglyceride issue in my late 30s. Both my parents fell ill and passed differently but each died of congestive heart failure. So this HBP subject is of great interest to me.

    Two years ago my internist switched me to Azor 5-40mg (very expensive!) from Verapamil and changed my diuretic to Spironolactone 25mg. I also take Simvastatin 20mg. In an effort to save money, I asked my cardiologist to prescribe the Szor components a la carte, so now I take Benicar 40mg and Amlodipine Besylate 5mg…but the Benicar, as it turns out, is still $50/month, just like Azor.

    Have you heard of a similar med combo that I and my doctors can consider that might be less expensive?

    Also I wanted to mention that years ago I read an article that offered an explanation as to why so many African Americans have HBP. The article intimated that having this trait might have helped our ancestors who did survive the Middle Passage. That same article also addressCycle Cell Anemia, a trait more common in our race, and how that trait was useful in our survival in Africa. You wouldn’t have happened to have run across any such information, would you?

    Keep up the great work, Jay Harold. You’re doing a great service to our populace.

    • Jay Fulce


      Please consult with your current doctors about alternate medications to fit your budget. Your doctors are the only people who can access and create a plan to fit your health care needs. Jay Harold is no different to me than Summer is to you!!! It’s my name.

      Thank you for sending me your questions and have a good day.

  18. Pat Monroe

    I was on metapolol for 2 years. In November 2015 I started having blood pressure spikes of 200/100 at times. My PCP did urine tests as I had abnormal labs. I also have type 2 diabetes so he referred me to an endocrinologist who changed my med to carvedilol. Seems to help but I still have spikes from time to time

  19. Rashell

    Just a curious question, can a lot of prescribed medications cause the HepC virus in someone who has not used intravenous drugs nor have they had multiple sexual partners. Tested HIV negative, and cancer screens negative.

    • Jay Fulce


      Jay Harold knows of any cases of Hep C transmission by prescription medications orally (by mouth). Here is some information from the Centers for Disease Control and Prevention (CDC) that sheds light on Hep C transmission.

      How is HCV transmitted?

      HCV is transmitted primarily through large or repeated percutaneous (i.e., passage through the skin) exposures to infectious blood, such as
      Injection drug use (currently the most common means of HCV transmission in the United States)

      Receipt of donated blood, blood products, and organs (once a common means of transmission but now rare in the United States since blood screening became available in 1992)

      Needlestick injuries in healthcare settings

      Birth to an HCV-infected mother

      HCV can also be spread infrequently through
      Sex with an HCV-infected person (an inefficient means of transmission)

      Sharing personal items contaminated with infectious blood, such as razors or toothbrushes (also inefficient vectors of transmission)

      Other health care procedures that involve invasive procedures, such as injections (usually recognized in the context of outbreaks)
      Learn more at

  20. Hello,I read your blogs named “New Black American High Blood Pressure Guidelines – Jay Harold” daily.Your story-telling style is witty, keep doing what you’re doing! And you can look our website about powerful love spells.

  21. Marjorie Whigham-Desir

    Mr Harold this info on the new hypertension guidelines is great, but not in an easy-to-read written fashion. This works for medical personnel as given, but the average person you want to read this may be just more confused. Simply written doesn’t mean simple-minded.
    I’m a former health writer and editor, I’d be happy to write for you if your looking for a freelancer.

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    • Recommendation 9

      Recommendation 9 of JAMA 8 states:

      The main objective of hypertension treatment is to attain and maintain goal
      BP. If goal BP is not reached within a month of treatment, increase the dose
      of the initial drug or add a second drug from one of the classes in recommendation 6
      (thiazide-type diuretic, CCB,ACEI, orARB).

      Recommendation 7
      In the general black population, including those with diabetes, initial antihypertensive
      treatment should include a thiazide-type diuretic or CCB. (For
      general black population: Moderate Recommendation – Grade B; for black
      patients with diabetes:

      Recommendation 8
      In the population aged 18 years with CKD, initial (or add-on) antihypertensive
      treatment should include an ACEI or ARB to improve kidney outcomes.
      This applies to all CKD patients with hypertension regardless of race
      or diabetes status.

      Learn more at

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