Table 5.
Trials Comparing Drug Classes in Older Black Hypertensive Patients
| Trial Name (n) | Age Range | Race/Ethnic NO. (%) | Intervention | Findings |
|---|---|---|---|---|
| LIFE[53] | 55–80 years (mean age 66.9) |
Blacks 533 (6) Whites 8503 (92) Asian 43 (0.5) Hispanic 100 (1) Other 14 (0.2) |
Losartan vs Atenolol | Interaction of race & treatment on CVD events (p = 0.005) CVD ↑ 55% in Blacks in the Losartan group |
| VALUE[54] | > 50 years (mean age 67.3) |
Blacks 658 (4.3) Whites 13,643 (89.1) Asian 535 (3.5) Other 474 (3.1) |
Valsartan vs Amlodipine | CVD↑ ~20% (ns) in Blacks in Valsartan group |
| ALLHAT[55] | > 50 years | Blacks 15,085 (35.5) Whites 19,977 (47.0) Hispanic 5,299 (12.5) |
Chlorthalidone vs Doxazosin, Amlopdipine, or Lisinopril | Chlorthalidone was superior in reducing BP by 4/1 mm Hg and CVD events (stroke and cardiovascular disease) compared to lisinopril in blacks |
| ACCOMPLISH[56] | ≥ 65 years (mean age 68.4) |
Blacks 1,416 (11.6) Whites 9,612 (79.0) Hispanic 623 (5.0) Other 477 (3.9) |
Benazepril-Amlodipine vs Benazepril-HCTZ (only 12.5–25 mg/day HCTZ) |
CVD ↓ 20% in Benazepril-amlodipine group p <0.001) |
Clinical Trial Acronyms: 1) ACCOMPLISH = Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension; 2) ALLHAT = The Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial; 3) LIFE = Losartan Intervention For Endpoint Reduction Trial; 4) VALUE = Valsartan Antihypertensive Long-term Use Evaluation.