Effectiveness of antihypertensive drugs in black people
Centre for Reviews and Dissemination
Record ID 32004000834
English
Authors' objectives:
This Effective Health Care bulletin summarises the research evidence on the effectiveness of antihypertensive drugs in black people.
Authors' recommendations:
Black people of African or Afro-Caribbean origin have higher blood pressure levels and a higher prevalence of hypertension compared to the general UK population. This is associated with higher rates of stroke morbidity and mortality.
There is insufficient evidence to conclude that any antihypertensive drug or drug combination is superior in reducing morbidity and mortality outcomes in hypertensive black people.
The commonly used antihypertensive drugs differ in their efficacy to lower blood pressure levels in black people. In particular, the blood pressure lowering effects of ACE inhibitors for diastolic and beta-blockers for systolic blood pressure were not significantly different from placebo. Betablockers might even increase systolic blood pressure.
Less than a quarter of the black participants in randomised controlled trials (RCTs) reduced blood pressure to predefined levels with limited or no dose titration. Higher doses might increase the efficacy of drugs, with the possible exception of beta-blockers.
The stepped approach advocated by the British Hypertension Society, involving first-line therapy with either a calcium channel blocker or a thiazide-type diuretic appears justified.
Future trials should enrol enough black participants to perform primary analyses based on ethnicity, and should report details on systolic and diastolic blood pressure reduction, goal blood pressures, adverse effects and dropouts.
Authors' methods:
Systematic review
Details
Project Status:
Completed
URL for project:
http://www.york.ac.uk/inst/crd/ehcb.htm
Year Published:
2004
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England
MeSH Terms
- Black People
- Antihypertensive Agents
- Ethnicity
- Hypertension
Contact
Organisation Name:
University of York
Contact Address:
University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,
Contact Name:
crd@york.ac.uk
Contact Email:
crd@york.ac.uk
Copyright:
Centre for Reviews and Dissemination
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.