New combination of drug therapies found to significantly lower blood pressure in blacksJuly 28, 2008
DETROIT- African-Americans have a higher risk of developing high blood pressure, the leading risk factor for cardiovascular disease, than other ethnic groups according to the American Heart Association. A research study performed at Wayne State University has found a new combination of drugs, a calcium blocker and an Angiotensin II Receptor blocker (ARB), to have the most significant drop in blood pressure in the first large-scale clinical trial in blacks.
John Flack, M.D., M.P.H., chair of the Department of Internal Medicine at WSU's School of Medicine and lead investigator of the research project, presented his findings to the National Medical Association on July 26. Dr. Flack spoke on a clinical trial for the combination of amlodipine and valsartan. The study showed significant decreases in high blood pressure for patients of African heritage.
"In the Ex-STAND Study involving almost 500 blacks, mostly from the U.S., including 17 percent of Hispanic origin, we showed in a randomized trial that the combination of amlodipine and valsartan lowered blood pressure more effectively than amlodipine monotherapy both before and after the optional addition of the diuretic hydrochlorothiazide," said Dr. Flack. "This is an important trial for black populations given that many will need combination therapy to attain blood pressure control and frequently in persons with diabetes and/or chronic kidney disease, a blocker of the renin angiotensin will also be needed."
The long available combination of calcium blockers with angiotensin converting enzyme inhibitors has not been well-tolerated by these patients because of severe side effects including angioedema (swelling of the skin and mucosa) and cough caused by the ACE inhibitor component. In Flack's new study, these side effects did not exist.
The study showed that black patients treated with the drug combination experienced a significantly higher reduction in systolic blood pressure than those on amlodipine alone. This marked the "most significant" blood pressure drop seen to date in such clinical studies, said the drug manufacturer, Novartis.
"The large blood pressure reductions seen in this trial were experienced by severe patients who have the most difficulty getting their blood pressure to healthy levels," said Flack. "These data may have a real impact on helping patients who are most at risk."
"Wayne State University is one of the eight Centers for Urban and African American Health selected by the National Institutes of Health," commented Dr. Hilary Ratner, vice president for Research at WSU. "Wayne State researchers across our campus collectively contribute to research devoted to improve the health of African Americans. Dr. Flack's leadership in this Center, along with his recent research findings, truly exemplifies Wayne State's commitment to the community, health disparities and our urban mission," Ratner added.
Wayne State University is one of the nation's pre-eminent public research universities in an urban setting. Through its multidisciplinary approach to research and education, and its ongoing collaboration with government, industry and other institutions, the university seeks to enhance economic growth and improve the quality of life in the city of Detroit, state of Michigan and throughout the world.
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