Open AccessBlood pressure response to metoprolol and chlorthalidone in European and African Americans with hypertension
Author(s) -
Mehanna Mai,
Gong Yan,
McDonough Caitrin W.,
Beitelshees Amber L.,
Gums John G.,
Chapman Arlene B.,
Schwartz Gary L.,
Johnson Julie A.,
Turner Stephen T.,
CooperDeHoff Rhonda M.
Publication year - 2017
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13094
Subject(s) - chlorthalidone , medicine , metoprolol , blood pressure , cardiology , antihypertensive drug , diastole
Despite the availability of many antihypertensive drug classes, half of patients with hypertension have uncontrolled blood pressure ( BP ). The authors sought to assess the effect of age on BP response in European American and African American patients with hypertension. Clinic BP from the PEAR 2 (Pharmacogenomics Evaluation of Antihypertensive Responses 2) study was used to estimate BP responses from baseline following sequential treatment with metoprolol 100 mg twice daily and chlorthalidone 25 mg daily for 8 to 9 weeks each, with a minimum 4‐week washout between treatments. BP responses to both drugs were compared in 159 European Americans and 119 African Americans by age with adjustment for baseline BP and sex. European Americans younger than 50 years responded better to metoprolol than chlorthalidone (diastolic BP : −9.6 ± 8.0 vs −5.9 ± 6.8 mm Hg, adjusted P = .003), whereas patients 50 years and older responded better to chlorthalidone than metoprolol (systolic BP : −18.7 ± 13.8 vs −13.6 ± 14.8 mm Hg, adjusted P = .008). African Americans younger than 50 years responded similarly to both drugs, whereas those 50 years and older responded better to chlorthalidone than metoprolol (−17.0 ± 13.2/−9.6 ± 7.5 vs −7.0 ± 18.6/−6.7 ± 9.3 mm Hg, adjusted P <.0001/.008). Therefore, age should be considered when selecting antihypertensive therapy in European and African American populations with hypertension.