Race Alone Shouldn’t Decide Blood Pressure Therapy

It has long seemed that some blood pressure medications work better than others for people of different racial backgrounds, but a new study shows that race by itself is a poor predictor of response to a particular treatment.

It has long seemed that some blood pressure medications work better than others for people of different racial backgrounds, but a new study shows that race by itself is a poor predictor of response to a particular treatment. “The long-held paradigm of using race as a major criterion upon which to select therapy should be abandoned,” Dr. John M. Flack from Wayne State University, Detroit, told Reuters Health. “A much greater source of variability in blood pressure response was within the groups, not between them.” Flack and his colleagues used data collected during a clinical trial of one type of blood-pressure lowering drug — the angiotensin-converting enzyme (ACE) inhibitor quinapril — to determine the influence of race on blood pressure response. The team reports in the medical journal Hypertension that blood pressure lowering with quinapril treatment was, on average, greater for whites than blacks. However, the response varied widely for both white and black participants, and the range overlapped substantially. Increasing age and obesity, as well as gender, accounted for much of the apparent racial differences in blood pressure response to quinapril treatment, the researchers note. “The results of these analyzes highlight the potential pitfalls of comparing blood pressure responses between race groups without adequate adjustment for a range of potential confounding variables,” the team concludes. Flack noted that few patients are adequately controlled with a single drug, however, and other types of drugs are added to lower blood pressure to target levels. Even so, doctors have to start somewhere when they begin a patient on blood pressure medication, Dr. Barry J. Materson from University of Miami School of Medicine, notes in a related editorial. Rather than “random initial drug selection,” he suggests that consideration of race and age “is a simple, cost-free, and relatively accurate way of guiding the choice of single-drug therapy for patients with stage 1 hypertension.” (SOURCE: Hypertension: Reuters Health News: June 2004.)