Why the study?
Genetic differences in sympathetic-vascular transduction signaling exist between Blacks and whites, meaning the lack of benefit of alpha-1 blockers seen in whites may not apply to Africans.
Does dual blockade with ACEI and alpha-1 blockers improve hypotensive response and clinical efficacy in Nigerians with hypertension and cardiovascular disease compared to ACEI alone?
Does dual blockade with ACEI and alpha-1 blockers improve hypotensive response and clinical efficacy in Nigerians with hypertension and cardiovascular disease compared to ACEI alone?
Combined ACEI and alpha-1 blocker therapy demonstrates synergistic hypotensive efficacy in Nigerian patients with hypertension and HFrEF, highlighting a population-specific pharmacodynamic benefit.
Answers are grounded in this paper and cite their sources.
Supports dual blockade investigation in Nigerians; leaves open clinical benefit over monotherapy in African CVD.
Genetic differences exist between Blacks and whites through sympathetic-vascular transduction signaling mechanisms. However, the lack of benefit of alpha-1 blockers in whites may not be applicable in Africans. The angiotensin II (Ang II) and alpha-1 receptor pathways are critical for vasoconstriction in Blacks. This article reviewed the consequence of the dual blockade among Nigerians, those with and without cardiovascular disease. Both receptors exhibited crosstalk and mutual regulations. Synergistic inhibition of Forearm vasoconstriction and hypotensive response to enalapril + prazosin (alpha-1 blocker [A1B]) occurred ( P < 0.05). High efficacy of dual blockade by angiotensin converting enzyme inhibitor (ACEI) + A1B was reported in hypertensive urgency, hypertensive crises, and heart failure (HF) with reduced ejection fraction congestive HF compared to ACEI ( P < 0.05). The high efficacy of dual blockade by ACEI + A1B + diuretics is beneficial for widespread use in Nigerians with cardiovascular disease.
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Eluwole et al. (2023) studied this question.
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