| Ethnic differences in blood pressure response to first and second-line antihypertensive therapies in patients randomized in the ASCOT Trial. | |
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MedLine Citation:
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PMID: 20725056 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Some studies suggest that blood pressure (BP)-lowering effects of commonly used antihypertensive drugs differ among ethnic groups. However, differences in the response to second-line therapy have not been studied extensively. METHODS: In the BP-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-BPLA), BP levels of European (n = 4,368), African (203), and South-Asian- (132) origin patients on unchanged monotherapy (atenolol or amlodipine) and/or on second-line therapy (added thiazide or perindopril) were compared. Interaction between ethnicity and BP responses (defined as end BP minus start of therapy BP) to both first- and second-line therapies were assessed in regression models after accounting for age, sex, and several other potential confounders. RESULTS: BP response to atenolol and amlodipine monotherapy differed among the three ethnic groups (interaction test P = 0.05). Among those allocated atenolol monotherapy, black patients were significantly less responsive (mean systolic BP (SBP) difference +1.7 (95% confidence interval: -1.1 to 4.6) mm Hg) compared to white patients (referent). In contrast, BP response to amlodipine monotherapy did not differ significantly by ethnic group. BP responses to the addition of second-line therapy also differed significantly by ethnic group (interaction test P = 0.004). On adding a diuretic to atenolol, BP lowering was similar among blacks and South-Asians as compared to whites (referent). However, on addition of perindopril to amlodipine, BP responses differed significantly: compared to whites (SBP difference -1.7 (-2.8 to -0.7) mm Hg), black patients had a lesser response (SBP difference 0.8 (-2.5 to 4.2) mm Hg) and South-Asians had a greater response (SBP difference -6.2 (-10.2 to -2.2) mm Hg). CONCLUSIONS: We found important differences in BP responses among ethnic groups to both first- and second-line antihypertensive therapies. |
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Authors:
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Ajay K Gupta; Neil R Poulter; Joanna Dobson; Sandra Eldridge; Francesco P Cappuccio; Mark Caulfield; David Collier; J Kennedy Cruickshank; Peter S Sever; Gene Feder; |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-08-19 |
Journal Detail:
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Title: American journal of hypertension Volume: 23 ISSN: 1941-7225 ISO Abbreviation: Am. J. Hypertens. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-24 Completed Date: 2010-12-07 Revised Date: 2011-06-30 |
Medline Journal Info:
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Nlm Unique ID: 8803676 Medline TA: Am J Hypertens Country: United States |
Other Details:
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Languages: eng Pagination: 1023-30 Citation Subset: IM |
Affiliation:
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ICCH, Imperial College London, London, UK. A.K.Gupta@imperial.ac.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Amlodipine / therapeutic use* Antihypertensive Agents / therapeutic use* Atenolol / therapeutic use* Blood Pressure / drug effects* Confounding Factors (Epidemiology) Continental Population Groups / statistics & numerical data Diuretics / therapeutic use* Drug Therapy, Combination Female Humans Hypertension / drug therapy*, ethnology* Male Middle Aged Multicenter Studies as Topic Perindopril / therapeutic use* Randomized Controlled Trials as Topic Sex Factors Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Diuretics; 29122-68-7/Atenolol; 82834-16-0/Perindopril; 88150-42-9/Amlodipine |
| Comments/Corrections | |
Comment In:
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Am J Hypertens. 2010 Sep;23(9):926-8
[PMID:
20733564
]
Curr Hypertens Rep. 2011 Feb;13(1):8-10 [PMID: 21080239 ] Am J Hypertens. 2010 Sep;23(9):929-30 [PMID: 20733565 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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