ACE Inhibitors Not A Good First Choice For Hypertension in Blacks

MedicalResearch.com Interview with:
Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI, Director of Research, Cardiac Catheterization Laboratory, Director, Cardiovascular Outcomes Group, The Leon H. Charney Division of Cardiology, Associate Professor of Medicine, New York University School of Medicine, New York, NY 10016.Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI
Director of Research, Cardiac Catheterization Laboratory,
Director, Cardiovascular Outcomes Group,
The Leon H. Charney Division of Cardiology,
Associate Professor of Medicine,
New York University Langone School of Medicine,
Principal Investigator ISCHEMIA-CKD trial

Medical Research: What is the background for this study? What are the main findings?

Dr. Bangalore: Angiotensin converting enzyme inhibitors (ACEi) are a common class of antihypertensive agents used for the management of hypertension. In many national and international hypertension guidelines, they are recommended as a first line agent. However, their efficacy and safety in hypertensive Blacks is not known.

In an analysis of hypertensive blacks we found that ACEi were consistently inferior to that of calcium channel blockers or thiazide diuretics with a higher risk of cardiovascular events.

Medical Research: What should clinicians and patients take away from your report?

Dr. Bangalore: Although ACEi are recommended as first line agents by national and international guidelines, they likely are not a great choice for hypertensive blacks. In fact few of the guidelines recognize this and recommend calcium channel blockers or diuretics for hypertensive blacks–consistent with the results seen in our study.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Bangalore: We need studies to figure out why ACEi do not work well in hypertensive blacks.

Citation:

Am J Med. 2015 Jun 11. pii: S0002-9343(15)00445-3. doi: 10.1016/j.amjmed.2015.04.034. [Epub ahead of print]

Outcomes with Angiotensin-Converting Enzyme Inhibitors vs Other Antihypertensive Agents in Hypertensive Blacks.

Bangalore S1, Ogedegbe G2, Gyamfi J3, Guo Y3, Roy J4, Goldfeld K3, Torgersen C3, Capponi L5, Phillips C6, Shah NR7.

Sripal Bangalore, MD, MHA, FACC, FAHA, FSCAI (2015). ACE Inhibitors Not A Good First Choice For Hypertension in Blacks 

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Last Updated on July 29, 2015 by Marie Benz MD FAAD

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