Racial Difference In ACE Inhibitor Response Seen In Children Too
(Reuters Health)
Similar to what has been shown in adults, race appears to influence the blood pressure response to ACE inhibitors in children.
As reported in the American Heart Journal for August, non-black children treated with fosinopril achieved the same average drop in blood pressure regardless of the dose. By contrast, a dose-response relationship was seen in black children, such that use of low doses may not achieve a clinically meaningful reduction in blood pressure.
The findings stem from a study of 253 hypertensive subjects, between 6 and 16 years of age, who were treated with fosinopril as part of a placebo-controlled trial. The racial composition of the group was 60.1% white, 20.6% black, 13.8% Hispanic, 2.0% Asian, 0.4% Native American, and 3.2% other.
As noted, after accounting for baseline blood pressure and body surface area, non-blacks showed no dose-response relationship with fosinopril, lead author Dr. Sharad Menon, from Duke University Medical Center in Durham, North Carolina, and colleagues note. "Non-blacks randomized to the low, medium and high dosages of fosinopril all had a mean decrease of 12 mm Hg in their sequential systolic blood pressure," they report.
In black subjects, however, the reduction in systolic blood pressure was greater as the fosinopril dose rose. At the highest dosage, an average reduction of 13 mm Hg was seen, whereas the lowest dosage produced a drop of just 5 mm Hg.
The results suggest that "black children treated with fosinopril for hypertension on average require higher doses to achieve adequate systolic blood pressure control than non-black children," the researchers conclude.
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