NDLI: Race and ethnicity in trials of antihypertensive therapy to prevent cardiovascular outcomes: a systematic review.

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Race and ethnicity in trials of antihypertensive therapy to prevent cardiovascular outcomes: a systematic review.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Park, Ina U. Taylor, Anne L.
Description	Country affiliation: United States Author Affiliation: Park IU ( Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minn, USA. parki@obgyn.ucsf.edu)
Abstract	PURPOSE: We wanted to systematically review (1) the participation of racial and ethnic minorities in clinical trials of antihypertensive drug therapy and (2) racial differences in the efficacy of these therapies for the prevention of cardiovascular outcomes. METHODS: MEDLINE, EMBASE, LILACS, African Index Medicus, and the Cochrane Library were searched from their inception to December 2005 for randomized controlled trials testing the efficacy of antihypertensive drug therapy in preventing myocardial infarction, stroke, revascularization, or cardiovascular death. MEDLINE was also searched from 2005 through 2006. The 2 authors independently assessed studies for inclusion and quality. RESULTS: Twenty-eight studies met inclusion criteria. Eight trials reported results by racial subgroup. Trials with black and Hispanic participants (ALLHAT, INVEST, VALUE) found similar primary outcomes, but ALLHAT found a greater magnitude of benefit for blacks on diuretic therapy compared with nonblacks. One trial (PROGRESS) compared Asians with non-Asians, reporting that angiotensin-converting enzyme inhibitors (vs placebo) were equally effective for preventing stroke in both groups. In the LIFE trial, post hoc analyses showed different outcomes for blacks and nonblacks, raising questions about the usefulness of angiotensin-receptor blockers as first-line antihypertensive agents in blacks. In 3 studies conducted exclusively in Asians (JMIC-B, FEVER, NICS-EH), calcium channel blockers were effective in preventing cardiovascular outcomes. No trials described cardiovascular outcomes in Native Americans. CONCLUSIONS: Five trials made interethnic group comparisons; 4 had similar primary outcomes for ethnic minorities and whites. Increased minority participation in future studies is needed to determine optimal prevention therapies, especially in outcome-driven trials comparing multidrug antihypertensive treatment regimens.
File Format	HTM / HTML
ISSN	15441709
e-ISSN	15441717
Journal	The Annals of Family Medicine
Issue Number	5
Volume Number	5
Language	English
Publisher	Annals of Family Medicine Inc
Publisher Date	2007-09-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Family Medicine Antihypertensive Agents Therapeutic Use Continental Population Groups Ethnic Groups Hypertension Drug Therapy Ethnology Randomized Controlled Trials As Topic Statistics & Numerical Data Research Subjects African Americans Asian Continental Ancestry Group Cardiovascular Diseases Prevention & Control European Continental Ancestry Group Global Health Hispanic Americans Research Support, U.s. Gov't, P.h.s.
Content Type	Text
Resource Type	Article
Subject	Family Practice

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