Blacks have a 1.3- times greater risk of nonfatal stroke, 1.8-times greater risk of fatal strokes, 1.5-times greater risk of HF, and 4.2-times greater risk of ESRD.S10.1-4 Hispanic Americans have lower rates of hypertension awareness and treatment than those of whites and blacks, as well as a high prevalence of comorbid CVD risk factors (eg, obesity, DM). In 2014, age-adjusted hypertension-attributable mortality rates per 1000 persons for non-Hispanic white, non-Hispanic black, and Hispanic- American men and women were 19.3 and 15.8, 50.1 and 35.6, However, Hispanics in the United States are a heterogeneous subgroup, and rates of both hypertension and its consequences vary according to whether their ancestry is from the Caribbean, Mexico, Central or South America, or Europe.S10.1-6 S10.1-8 Hispanics from Mexico and Central America have lower CVD rates than US whites, whereas those of Caribbean origin have higher rates. Thus, pooling of data for Hispanics may not accurately reflect risk in a given patient. Finally, the excess risk of CKD out- comes in at least some blacks with hypertension may be due to the presence of high-risk APOL1 (apolipoprotein L1) genetic The rate of renal decline associated with this genotype appears to be largely unresponsive to either BP lowering or RAS inhibition.S10.1-9 S10.1-12 10.1.1. Racial and Ethnic Differences in Treatment Recommendations for Race and Ethnicity References that support recommendations are summarized in Online Data Supplement 51. COR LOE Recommendations I B-R 1. In black adults with hypertension but without HF or CKD, including those with DM, initial antihypertensive treatment should include a thiazide-type diuretic or I C-LD 2. 