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| |  ASH: African Americans Respond Well to Angiotensin Receptor Blockers By Jill Stein NEW YORK, NY -- May 25, 2004 -- Angiotensin receptor blocker agents work as well as calcium channel blockers to reduce high blood pressure and may also be more potent in reducing inflammatory cytokines. "These studies, I believe, will help dispel the notion that black hypertensive patients have to be treated with calcium channel blockers," said lead researcher Kenneth Jamerson, MD, Associate Professor of Medicine, University of Michigan, Ann Arbor, Michigan. In two poster presentations here on May 21st at the American Society of Hypertension Nineteenth Annual Meeting, Dr. Jamerson presented the results of the African American Diovan (valsartan) Amlodipine (Norvasc) Clinical Efficacy (AADVANCE) trial. Low-dose valsartan at 160 mg plus hydrochlorothiazide was as effective as high-dose amlodipine in lowering blood pressure for the full 24-hour period in African Americans, Dr. Jamerson said. The same drug combination also produced a significantly greater reduction in procollagen 1, a marker of inflammation. "Although- African Americans suffer disproportionately from high blood pressure, they are less likely to receive treatments that not only control blood pressure, but also provide added protection against vascular damage," Dr. Jamerson said. "AADVANCE has important clinical implications because it identifies an effective way to overturn this disparity in care." The AADVANCE study was a first prospective, randomized, double blind, parallel-group, multicenter trial that enrolled 383 adult African American men and women with mild to moderate hypertension. Patients were underwent a 2-3 week placebo run-in and were randomized to 160 mg valsartan or 5 mg amlodipine for 2 weeks, followed by 10 weeks of treatment with force-titrated valsartan HCT 160/12.5 mg or amlodipine 10 mg. Patients wore 24-hour ambulatory blood pressure monitoring devices before and after the 12-week study. They were also evaluated for changes in levels of inflammation markers -- C-reactive protein, plasminogen activator inhibitor-1, and procollagen 1 Results show that after 12 weeks, both drugs had significantly reduced mean blood pressure levels over the course of the 24-hour monitoring period. "The time point graphs were virtually superimposable," Dr. Jamerson said, which showed that both drugs reduced blood pressure similarly over the course of the 24 hours. The results, he said, showed statistical significance at the P < .0001 level. There was no difference in the effect of either drug on levels of C-reactive protein or plasminogen activator inhibitor-1, but procollagen 1 was reduced among those patients on valsartan and was increased in those patients on amlodipine. That difference reached statistical significance at the P = .0036 level. Patients treated with valsartan had fewer adverse side effects than with amlodipine. Dr. Jamerson noted that 5.8% of those on amlodipine experienced peripheral edema compared with 1.7% of those on valsartan, reaching significance at the P = .0309 level.
[Presentation titles: "Comparison of the effects of valsartan HCT versus amlodipine on 24-hour ABPM blood pressure in African Americans with mild to moderate hypertension: the AADVANCE trial." Poster #P218. And: "The effects of valsartan HCT versus amlodipine on inflammatory markers in hypertensive African Americans: the AADVANCE trial." Poster #P219]
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