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The efficacy of beta-adrenoceptor and calcium-entry blockers in hypertensive blacks
J R M'Buyamba-Kabangu1, M Tambwe
1Department of Internal Medicine, University of Kinshasa (Unikin), Zaire.
Insights
Beta-adrenoceptor blockers (BB) are less effective for hypertension in Black patients compared to diuretics. Calcium-entry blockers (CEB) show comparable efficacy to diuretics and are effective in Black patients.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Hypertension treatment efficacy varies across racial groups.
- Beta-adrenoceptor blockers (BB) and calcium-entry blockers (CEB) are common antihypertensive agents.
- Understanding differential drug response in Black patients is crucial for effective hypertension management.
Purpose of the Study:
- To review the efficacy of beta-adrenoceptor blockers (BB) and calcium-entry blockers (CEB) in treating hypertension specifically in Black patients.
- To compare the effectiveness of BB and CEB against other antihypertensive agents and placebos in this population.
Main Methods:
- Review of existing data on hypertension treatment in Black patients.
- Comparative analysis of BB and CEB efficacy versus diuretics and placebo.
- Evaluation of blood pressure control in Black patients compared to white and Indian patients.
Main Results:
- Beta-adrenoceptor blockers (BB) monotherapy showed limited efficacy in most Black hypertensive patients, performing similarly to placebo.
- BBs were less effective in lowering blood pressure in Black patients compared to diuretics.
- When combined with diuretics, BBs demonstrated equipotent efficacy in Black and white patients.
- Calcium-entry blockers (CEB) were found to be as efficacious as diuretics in Black patients.
- CEBs lowered blood pressure effectively in both Black and white patients and served as effective adjunctive therapy with diuretics.
Conclusions:
- Black patients with hypertension exhibit hyporesponsiveness to beta-adrenoceptor blockers (BB) monotherapy.
- Calcium-entry blockers (CEB) are a highly effective treatment option for hypertension in Black patients, comparable to diuretics.
- Factors such as hypertension severity, low plasma renin, blunted sympathetic activity, and high intracellular sodium may contribute to the differential response to CEB therapy in Black individuals.
Abstract:
The data on treatment of hypertension in black patients with beta-adrenoceptor blockers (BB) or calcium-entry blockers (CEB) have been reviewed. There is much evidence that in monotherapy BB are no better than inert placebo for the majority of hypertensive black patients. Their hypotensive action in blacks is less than that induced by other antihypertensive agents, mainly diuretics. Comparative evaluation of the responsiveness of blacks, whites, and Indians to BB therapy showed a poorer control of blood pressure (BP) among blacks than among nonblacks. However, when combined with diuretic therapy, BBs are equipotent in blacks and whites. The reasons for the hyporesponsiveness of black patients to BB therapy are not fully understood. On the other hand, CEBs appear to be as efficacious as diuretic therapy in hypertensive blacks. In addition, they lower blood pressure to the same extent in black and white patients. They are also proven to be effective adjunctive therapy to diuretics for hypertension in blacks. The reason for the better responsiveness of blacks to CEB therapy might include the severity of hypertension in blacks, their low plasma renin, their blunted sympathetic activity, and their high intracellular sodium concentration.