Hypertension drugs work for blacks and whites

A study downplays the role of race in an individual's response to medications, but continuing to study disparities may help improve hypertension treatment for all.

By Victoria Stagg Elliott, AMNews staff. March 22/29, 2004.

Differences in how blacks and whites respond to antihypertensive drugs are small, and race should not be a determining factor in whether to prescribe them, according to a paper published in the March issue of Hypertension. The study was released online a month earlier.

"Physicians are taught that blacks and whites respond differently," said Ashwini R. Sehgal, MD, lead author and associate professor at Case Western Reserve University in Cleveland. "But there isn't really that much difference."

Dr. Sehgal performed a meta-analysis of 15 large studies that included data about race in connection to response to antihypertensives in an attempt to quantify how long documented differences may actually impact patients.

He found differences, but he also found a great deal of similarities. For example, 90% of whites and blacks had comparable changes in blood pressure after treatment with beta-blockers even though several studies have shown this treatment results in Caucasians' readings decreasing an average of six points more than that of African-Americans.

"What I'm arguing is that when we look at different racial groups we should look not just at the average differences but also at the extent of overlap," said Dr. Sehgal. "And when we make decisions about what drugs to use in particular patients, we shouldn't be focusing so much on their race."

This study is the latest wrinkle in the ongoing debate about racial differences in drug response and how clinically relevant these factors are for individual patients.