Blood pressure drugs differ for blacks, whites

April 1, 2004

Last Updated: 2004-04-01 15:20:09 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Several types of drugs can lower blood

pressure, but some may be better than others for certain people.

Despite producing similar reductions in blood pressure, the beta-blocker

drug atenolol (brandname, Tenormin) has advantages over the

angiotensin-blocker losartan (Cozaar) for black patients with

hypertension and enlargement of the left side of the heart, according to

a report in the Journal of the American College of Cardiology.

The finding comes from a trial called the LIFE study that was conducted

in several countries, which showed overall that losartan provided better

cardiovascular protection than atenolol in a broad population of

hypertensive patients.

However, based on an apparent effect of ethnic background in the LIFE

study, Dr. Stevo Julius from University of Michigan, Ann Arbor, and

colleagues, conducted a new analysis comparing cardiovascular events in

black and non-black patients.

They found that white patients had a lower risk of cardiovascular

mortality, stroke, or heart attack with losartan, whereas black patients

appeared to have a lower risk with atenolol.

The researchers then focused on data from the U.S. arm of the study,

where most of the black patients were enrolled.

During the first two years of treatment, outcomes were similar for

losartan and atenolol. After four years, however, the cardiovascular

event rate for black patients was 15.3 percent in the losartan group,

but only 9.7 percent in the atenolol group.

As in the overall LIFE study, blood pressure reductions in black

patients were similar with losartan and with atenolol.

" We believe that our finding is sufficiently convincing to generate the

hypothesis that black patients with hypertension and (left heart

enlargement) might not respond as favorably to losartan-based treatment

as non-black patients, with respect to cardiovascular outcomes, " the

authors conclude, " and that these data do not support a recommendation

for losartan as a first-line treatment for this purpose. "

SOURCE: Journal of the American College of Cardiology, March 17, 2004.

I'll tell you where to go!

Mayo Clinic in Rochester

s Hopkins Medicine

Recommended Posts