Document Detail


Essential hypertension of Caribbean Hispanics: sodium, renin, and response to therapy.
MedLine Citation:
PMID:  12147929     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Little is known about essential hypertension in Hispanic Americans, despite the fact that they are the fastest-growing minority in the United States and have a disproportionate degree of hypertensive target organ damage. The authors studied 89 Caribbean Hispanic hypertensive patients who participated in six double-blind, randomized trials of antihypertensive agents. Demographics, laboratory data, sodium excretion, plasma renin activity, and atrial natriuretic peptide were obtained after 3-4 weeks on placebo. Blood pressure responses to angiotensin-converting enzyme (ACE) inhibitors, beta blockers, calcium channel blockers, hydrochlorothiazide (HCTZ), and fixed combinations of ACE inhibitors and HCTZ, were compared to the placebo values after 8-12 weeks of treatment. Patients had a multiple risk factor profile (obesity and diabetes) and a wide spectrum of blood pressure elevation, left ventricular hypertrophy, and hypertensive renal damage. Urine sodium excretion rates indicated inability to comply with salt restriction in 65% of patients. Plasma renin activity was lower than that of Hispanic normotensive controls, and 62% of patients had low-renin essential hypertension by renin profiling to sodium excretion. On analysis of variance, blood pressure reductions by calcium channel blockers, HCTZ, and ACE inhibitor/HCTZ combinations were significantly greater than that with placebo, while those of ACE inhibitors and beta blockers as monotherapy were not. The authors conclude that essential hypertension of Caribbean Hispanics is associated with multiple risk factors and is largely of the low-renin type. Responses to therapy are consistent with those observed in other populations with the low-renin phenotype and suggest salt-sensitivity of blood pressure in this population. Confirmation of the latter has implications for prevention and treatment of essential hypertension in Hispanics.
Authors:
Cheryl L Laffer; Fernando Elijovich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  4     ISSN:  1524-6175     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:    2002 Jul-Aug
Date Detail:
Created Date:  2002-07-30     Completed Date:  2002-09-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  266-73     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Le Jacq Communications, Inc.
Affiliation:
Department of Medicine, Mount Sinai School of Medicine, City University of New York, NY, USA. cheryl_laffer@grmerc.net
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use
Female
Hispanic Americans*
Humans
Hypertension / drug therapy,  ethnology*
Male
Middle Aged
New York City / epidemiology
Renin / blood
Risk Factors
Sodium / urine
West Indies / ethnology
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 7440-23-5/Sodium; EC 3.4.23.15/Renin

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


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