Does the choice of antihypertensive regimen (such as thiazide diuretics vs calcium channel blockers) improve blood pressure control in treated African American adults?
In African American adults, thiazide diuretics were associated with better blood pressure control compared to non-thiazide regimens and calcium channel blocker monotherapy.
Hypertension treatment regimens used by African American adults in the Jackson Heart Study were evaluated at the first two clinical examinations (2415 treated hypertensive persons at examination I exam I, 2000-2004; 2577 at examination II exam II, 2005-2008). Blood pressure (BP) was below 140/90 mm Hg for 66% and 70% of treated participants at exam I and exam II, respectively. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure treatment targets were met for 56% and 61% at exam I and exam II, respectively. Persons with diabetes or chronic kidney disease were less likely to have BP at target, as were men compared with women. Thiazide diuretics were the most commonly used antihypertensive medication, and persons taking a thiazide were more likely to have their BP controlled than persons not taking them; thiazides were used significantly less among men than women. Although calcium channel blockers are often considered to be effective monotherapy for African Americans, persons using calcium channel blocker monotherapy were significantly less likely to be at target BP than persons using thiazide monotherapy.
Harman et al. (Mon,) studied this question.