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Should Treatment Differ in African-American and Caucasian Patients?

  • W. Dallas Hall
Chapter
Part of the Current Clinical Practice book series (CCP)

Abstract

Should treatment differ in African-Americans and Caucasians? The answer is yes and no. Yes, the choice of initial monotherapy should differ in hypertensive African-Americans and Caucasians. No, the selection and use of antihypertensive drugs should not differ once the patient needs the addition of a second or third drug. No, the compelling clinical indications for specific antihypertensive drug classes do not differ between African-Americans and Caucasians.

Keywords

Resistant Hypertension Joint National Committee Goal Blood Pressure Hypertension Optimal Treatment Dietary Salt Intake 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI) (1997) The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 27: 2413–2446.Google Scholar
  2. 2.
    Hall WD (1999) A rational approach to the treatment of hypertension in special populations. Am Fam Physician 60: 156–162.PubMedGoogle Scholar
  3. 3.
    Hall WD, Israili ZI (1995) The use of ACE inhibitors in blacks and whites. In Schacter M, ed. ACE Inhibitors: Current Use and Future Prospects, London: Martin Dunitz pp. 123–143.Google Scholar
  4. 4.
    Jamerson K (1998) Calcium antagonists in African-American patients. Ethn Dis 8: 120–123.PubMedGoogle Scholar
  5. 5.
    Saunders E, Weir MR, Kong BW, et al. (1990) A comparison of the efficacy and safety of a (3-blocker, a calcium channel blocker, and a converting enzyme inhibitor in hypertensive blacks. Arch Intern Med 150: 1707–1713.PubMedCrossRefGoogle Scholar
  6. 6.
    Weir MR, Gray JM, Paster R, et al. (1995) Differing mechanisms of action of angiotensin-converting enzyme inhibition in black and white hypertensive patients. Hypertension 25: 124–130.CrossRefGoogle Scholar
  7. 7.
    Weir MR, Chrysant SG, McCarron DA, et al. (1998) Influence of race and dietary salt on the antihypertensive efficacy of an angiotensin-converting enzyme inhibitor or a calcium channel antagonist in salt-sensitive hypertensives. Hypertension 31: 1088–1096.PubMedCrossRefGoogle Scholar
  8. 8.
    Materson BJ, Reda DJ, Cushman WC, et al. (1993) Single-drug therapy for hypertension in men: a comparison of six antihypertensive agents with placebo. N Engl J Med 328: 914–921.PubMedCrossRefGoogle Scholar
  9. 9.
    Materson BJ, Reda DJ, Cushman WC, et al. (1995) Department of Veterans Affairs single-drug therapy of hypertension study: revised figures and new data. Am J Hypertens 8: 189–192.PubMedCrossRefGoogle Scholar
  10. 10.
    Katz LA, Cobbol C (1988) Treating black hypertensives with Capozide. Am J Hypertens 1 (Suppl.): 224S - 226S.PubMedCrossRefGoogle Scholar
  11. 11.
    Prisant LM, Neutel JM, Ferdinand K, et al. (1999) Low-dose combination therapy as first-line antihypertensive treatment for blacks and nonblacks. J Natl Med Assoc 91: 40–48.PubMedGoogle Scholar
  12. 12.
    Mehta SS, Wilcox CS, Schulman KA (1999) Treatment of hypertension in patients with comorbidities. Am J Hypertens 12: 333–340.PubMedGoogle Scholar
  13. 13.
    Wright JT Jr (1999) VA First Annual Hypertension Conference. Improvement in the Management of Hypertension in 2000 and Beyond: Challenges and Opportunities. Washington, DC.Google Scholar
  14. 14.
    Hansson L, Zanchetti A (1997) The Hypertension Optimal Treatment (HOT) study: 24-month data on blood pressure and tolerability. Blood Press 6: 313–317.PubMedCrossRefGoogle Scholar
  15. 15.
    UK Prospective Diabetes Study Group (1998) Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes. BMJ 317: 703–713.Google Scholar
  16. 16.
    Bakris GL (1999) Renal disease progression. Semin Hypertens Management 2 (1): 12–15.Google Scholar
  17. 17.
    Veterans Administration Cooperative Study Group on Antihypertensive Agents (1982) Comparison of propranolol and hydrochlorothiazide for the treatment of hypertension. I. Results on short-term titration with emphasis on racial differences in response. JAMA 248: 1996–2003.Google Scholar
  18. 18.
    Veterans Administration Cooperative Study Group on Antihypertensive Agents (1982) Racial differences in response to low-dose captopril are abolished by the addition of hydrochlorothiazide. Br J Clin Pharmacol 14 (Suppl. 2): 97S - 101S.Google Scholar
  19. 19.
    Oparil S, Calhoun DA (1998) Managing the patient with hard-to-control hypertension. Am Fam Physician 57: 1007–1013.PubMedGoogle Scholar
  20. 20.
    Morisky DE, Green LW, Levine DM (1986) Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 24: 67–74.PubMedCrossRefGoogle Scholar
  21. 21.
    Graves JW, Bloomfield RL, Buckalew VM Jr (1989) Plasma volume in resistant hypertension: guide to pathophysiology and therapy. Am J Med Sci 298: 361–365.PubMedCrossRefGoogle Scholar
  22. 22.
    Soumeral SB, McLaughlin TJ, Spiegelman D, et al. (1997) Adverse outcomes of underuse of 13-blockers in elderly survivors of acute myocardial infarction. JAMA 277: 115–121.CrossRefGoogle Scholar
  23. 23.
    Gottlieb SS, McCarter RJ, Vogel RA (1998) Effect of beta-blockade on mortality among high-risk and low-risk patients after myocardial infarction. N Engl J Med 339: 489–497.PubMedCrossRefGoogle Scholar
  24. 24.
    Dries DL, Exner DV, Gersh BJ, et al. (1999) Racial differences in the outcome of left ventricular dysfunction. N Engl J Med 340: 609–616.PubMedCrossRefGoogle Scholar
  25. 25.
    Smith NL, Psaty BM, Pitt B, et al. (1998) Temporal patterns in the medical treatment of congestive heart failure with angiotensin-converting enzyme inhibitors in older adults, 1989 through 1995. Arch Intern Med 158: 1074–1080.PubMedCrossRefGoogle Scholar
  26. 26.
    Stafford RS, Saglam D, Blumenthal D (1997) National patterns of angiotensinconverting enzyme inhibitor use in congestive heart failure. Arch Intern Med 157: 2460–2464.PubMedCrossRefGoogle Scholar
  27. 27.
    Lapuerta P, L’Italien GJ (1999) Awareness, treatment, and control of systolic blood pressure in the United States. Am J Hypertens 12 (4, pt. 2): 92A (abstract).CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

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  • W. Dallas Hall

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