Race-based Therapy for Hypertension: Possible Benefits and Potential Pitfalls

Keith C. Ferdinand; Daphne P. Ferdinand


Expert Rev Cardiovasc Ther. 2008;10(6):1357-1366. 

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Expert Commentary

Race/ethnicity is a poor proxy for genetic variation but can potentially unmask subtle differences in antihypertensive therapy and lead to a more focused intervention. Future research using ancestry rather than race, specifically related to hypertension, may demonstrate true genetic differences in response seen across racial groups. As RAAS-blocking agents are more widely utilized, the apparent lack of equal BP-lowering and diminished positive outcomes with ACEIs/ARBs in various populations will be explained. Despite potential advances in genetic research, the relationship between response to RAAS, specifically with ACEIs and ARBs, may hinge on better control of high sodium intake and obesity, especially in African-Americans. The troubling higher rates of angioedema and cough in Blacks and Asians may eventually be linked to a gene or set of genes although, again, environment may play a large role.


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