Document Detail


Comparative antihypertensive efficacy of angiotensin receptor blocker-based treatment in African-American and white patients.
MedLine Citation:
PMID:  16227761     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Blood pressure (BP) reductions with agents that block the renin-angiotensin system are regarded as less effective as monotherapy in African Americans than other ethnic groups. This practice-based study compares the efficacy of an angiotensin receptor blocker-based regimen in African-American and Caucasian patients. Included in the 10-week study were 173 African-American and 1296 Caucasian patients. Efficacy was based on differences in 24-hour ambulatory BP. After baseline ambulatory BP monitoring and office BPs were obtained, all patients were started or switched to the angiotensin receptor blocker telmisartan, 40-80 mg daily, plus hydrochlorothiazide 12.5 mg daily (if needed for office BP control: <140/90 mm Hg). More African Americans required the addition of a low-dose thiazide diuretic than Caucasians (47.3% vs. 34.9%; p=0.021). Once patients with white coat hypertension were excluded (i.e., those with baseline ambulatory BP monitoring <130/80 mm Hg), ambulatory BP monitoring changes were similar between groups. A greater proportion of African Americans than Caucasians without white coat hypertension also needed combination therapy (52.1% vs. 39.5%; p=0.04). While achievement of BP goal was similar between groups by office criterion (<140/90 mm Hg), differences were noted by ambulatory BP monitoring (<130/80 mm Hg) (48.0% in African American vs. 63.2% in Caucasians; p=0.01) despite the same BP reductions, reflecting higher baseline values in African Americans. We conclude that an angiotensin receptor blocker as part of a BP-lowering strategy is effective in previously untreated African-American patients, although a higher proportion will require the use of a diuretic compared with Caucasians.
Authors:
George L Bakris; David Hg Smith; Thomas D Giles; William B White; Giora Davidai; Michael A Weber
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  7     ISSN:  1524-6175     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-17     Completed Date:  2006-03-23     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  587-95; quiz 596-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans*
Aged
Angiotensin II Type 1 Receptor Blockers / therapeutic use*
Antihypertensive Agents / therapeutic use*
Benzimidazoles / therapeutic use
Benzoates / therapeutic use
Blood Pressure / drug effects
Blood Pressure Monitoring, Ambulatory
Circadian Rhythm / drug effects
Double-Blind Method
European Continental Ancestry Group*
Female
Humans
Hydrochlorothiazide / therapeutic use
Hypertension / drug therapy*,  ethnology*,  physiopathology
Male
Middle Aged
Prospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Benzimidazoles; 0/Benzoates; 0J48LPH2TH/Hydrochlorothiazide; U5SYW473RQ/telmisartan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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