Reply to an Answer

balow,   Thanks for your question, which I have been thinking about for the last several days.  In essence, there is no medication that comes to mind that would be "best" for African American Men.   When thinking about the different classes of medication used in the treatment of high blood pressure, ACE inhibitors tend to require higher doses in black people to achieve control when compared to white people.  Rather than abandoning this class of medication, doctors need to push the dose higher until they get the desired response.    Other than this, all of the medications should be effective.  Blood pressure response to medication varies from individual to individual and there is no "cook book" method to treating high blood pressure.  If this were the case, you wouldn't need a physician, who uses his knowledge and experience to select the right medication for each patient.  Establishing the right regimen can take time.  Much trial and error is sometimes necessary and patience is required by the patient, as well as the doctor.   Don't give up!  Treatment for you hypertension is most important if you want to avoid complications like heart disease, kidney disease, stroke, and vascular disease.  Be sure your doctor has considered possible causes for your hypertension, which could be a reason it has been so resistant.  One important source is your kidneys and the arteries that supply blood to them.  If no source is found then you have essential hypertension, the most common form, which has no cause.  If your primary care physician is unsuccessful in controlling your pressure, you might have to see an internist.  If the internist is also unsuccessful, then your next step is a kidney specialist (nephrologist) who also specializes in treating high blood pressure.    I hope this information has been helpful.  Best wishes.   Martin Cane, M.D.