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Beta Blocker Therapy in African American Patients with Heart Failure

Heart Failure Reviews volume 9, pages 161–167 (2004)Cite this article

Abstract

Data from a number of clinical trials of beta blocker therapy in heart failure, although limited in the size of African American patients included, suggest that they achieve a similar benefit as Caucasians. African Americans were usually at higher risk when enrolled in all of these studies with a higher incidence of hypertension and diabetes mellitus. The only exception is the Beta Blocker Evaluaition of Survival Trial (BEST) that studied the efficacy of Bucindolol in heart filaure. In that study there appeared to be a unique differential effect in Afrcian Americans compared to Caucasians which may have been inpart related to the severity of the disease.

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References

  1. Gillum RF. The epidemiology of cardiovascular disease in Black Americans. New Engl J Med 1996; 335: 1597-1599.

    PubMed  Google Scholar 

  2. Gillum RF. Heart failure in the United States 1970-1985. Am Heart J 1987; 113: 1043-1045.

    PubMed  Google Scholar 

  3. Centers for Disease Control. 1998 changes in mortality from heart failure-United States. Mor Mortal Wkly 1980-1995;Re. 47(30)

  4. The SOLVD Investigators. Effects of enalapril on mortal-ity and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med 1992; 327: 685-691.

    Google Scholar 

  5. Dries DL, Exner DV, Gersh BJ, Cooper HA, et al. Racial differences in the outcome of left ventricular dysfunction. N Engl J Med 1999; 340: 609-616.

    PubMed  Google Scholar 

  6. ALLHAT Officers and Coordinators for ALLHAT Col-laborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. diuretic. JAMA 2002; 288: 2981-2997.

    Google Scholar 

  7. Carson P, Ziesche S, Johnson G, Cohn JN. Racial differences in response to therapy for heart failure: Analysis of the vasodilator-Heart failure trials. J of Cardiac Failure 1999; 5: 178-187.

    Google Scholar 

  8. Packer M, Bristow MR, Cohn JN, et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 1996; 334: 1349-1355.

    PubMed  Google Scholar 

  9. Packer M, Coats AJS, Fowler MB, et al. Effect of carvedilol on survival in severe chronic heart failure. N Engl J Med 2001; 344: 1651-1658.

    PubMed  Google Scholar 

  10. Merit-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL randomized intervention trial in congestive heart failure (MERIT-HF). Lancet 1999; 353: 2001-2007.

    Google Scholar 

  11. The Beta-Blocker Evaluation of Survival Trial Investigators. A trial of the beta-blocker bucindolol in patients with advanced chronic heart failure. New Engl J Med 2001; 344: 1659-1667.

    Google Scholar 

  12. Yancy CW, Fowler MB, Colucci WS, et al. Race and the response to adrenergic blockade with carvedilol in patients with chronic heart failure. New Engl J Med 2001; 344: 1651-1658.

    PubMed  Google Scholar 

  13. Goldstein S, Deedwania P, Gottlieb S, Wikstrand J for the MERIT-HF Study Group. Metoprolol CR/XL in black patients with heart failure (from the metoprolol CR/XL randomized intervention trial in chronic heart failure). Am J Cardiol 2003; 92: 478-480.

    PubMed  Google Scholar 

  14. Plehn JF, Krause-Steinrauf H, Anand IS, Gottleib S, O'Connor CM, Silver M, White M, Carson. Effect of race on cause specific mortality in BEST. Circulation 2000; 102: II-779.

    Google Scholar 

  15. Eichhorn EJ, Domanski MJ, et al. Hemodynamic functional and neurohormonal responses to beta-blockade in black vs. non-black patients in BEST. Circulation 2000; 102: II-778.

    Google Scholar 

  16. Eichhorn EJ, Domanski MJ, Adams K, Anderson JL Bristow MR Carson P, Yancy C, Krause-Steinrauf H. Effect of Beta-Blockade on Mortality in African Americans: The Beta-blocker evaluation survival trial. Circulation 2000; 102: II-778.

    Google Scholar 

  17. Swedberg K, Bristow MR, Cohn JN, et al. The effects of moxonidine SR, an imidazoline agonist, on plasma nore-pinephrine in patients with congestive heart failure. Circulation 1996; 94: 690-697.

    PubMed  Google Scholar 

  18. Yancy CW. Heart failure therapy in blacks: Same or different illness? In: Willenheimer R, Swedberg K, eds. Tailoring Heart Failure Therapy, 1st edn. A Martin Dunitz Book, Lund: Taylor & Francis, 2003; 55-72.

  19. Xie HG, Kim RA, Wood AJ, Stein CM. Molecular basis of ethnic differences n drug disposition and response. Annu Rev Phamacol Toxicol 2001; 41: 815-850.

    Google Scholar 

  20. Small KM, Forbes SL, Rhaman FF, Bridges KM, Ligett SB. A four amino acid deletion polymorphism in the third intracellular loop of the human alpha 2c-adrenergic receptor confers impaired coupling to multiple effectors J Bio Chem 2000; 275: 23059-23064.

    Google Scholar 

  21. Borjesson M, Magnusson Y, Andersson B. A novel polymorphism in the gene coding for the beta-1 receptor associated with survival in patients with heart failure. JACC 1999; 33: 261A.

    Google Scholar 

  22. Johnson JA, Burlew BS, Stiles RN. Racial differences in beta adrenoreceptor mediated responsiveness. J Cardio-vasc Pharmacol 1995; 25: 90-96.

    Google Scholar 

  23. Stein CM, Lang CC, Nelson R, Brown M, Wood AJJ. Va-sodilation in Black Americans: Attenuated nitric oxide-mediated responses. Clin Pharmacol Ther 1997; 62: 436-443.

    PubMed  Google Scholar 

  24. Cardillo C, Kilcone CM, Cannon III RO, Panza JA Attenuation of cylic nucleotide-mediated smooth muscle relaxation in blacks as a cause of racial differences in vasodilator function. Circulation 1999; 99: 90-95.

    PubMed  Google Scholar 

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  1. Henry Ford Hospital, Detroit, Michigan, 48202, USA

    Sidney Goldstein

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  1. Sidney Goldstein
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Correspondence to Sidney Goldstein.

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Goldstein, S. Beta Blocker Therapy in African American Patients with Heart Failure. Heart Fail Rev 9, 161–167 (2004). https://doi.org/10.1023/B:HREV.0000046371.67163.a4

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  • DOI: https://doi.org/10.1023/B:HREV.0000046371.67163.a4

  • beta blockers
  • heart failure
  • african-americans