Why do hypertensive patients of African ancestry respond better to calcium blockers and diuretics than to ACE inhibitors and β-adrenergic blockers? A systematic review.
Why do hypertensive patients of African ancestry respond better to calcium blockers and diuretics than to ACE inhibitors and β-adrenergic blockers? A systematic review.
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DOI：
10.1186/1741-7015-11-141
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发表时间：
2013-05-30
期刊：
影响因子：
9.3
通讯作者：
Seedat YK
中科院分区：
文献类型：
--
作者：
Brewster LM;Seedat YK
临床医生被鼓励在治疗非洲血统患者的高血压时采取个体化的方法，但对于为什么单个患者对钙阻滞剂和利尿剂反应良好，而对抑制肾素-血管紧张素系统的药物和β-肾上腺素能阻滞剂的反应通常减弱，人们知之甚少。因此，我们系统地综述了与非洲血统患者对降压药物治疗的不同药物反应相关的因素。使用系统综述叙事综合法的方法，我们寻找可以解释非洲血统患者降压药物不同临床疗效的已发表或未发表的研究。从PubMed、EMbase、Lilacs、African Index Medicus以及FDA和European Medicines Agency的数据库被搜索，从最初到2012年6月，没有语言限制。我们检索了3,763篇文献，包括72篇报告，主要涉及抗高血压药物、钙阻滞剂、利尿剂、干扰肾素-血管紧张素系统的药物和β-肾上腺素能阻滞剂四大类。药代动力学、血浆肾素和基因多态性不能很好地预测非洲血统患者对降压药的反应。一种新的观点认为，低一氧化氮和高肌酸激酶可能解释个体对降压药的反应，这与之前的观察结果一致，但目前临床数据非常有限。关于为什么非洲血统的患者对降压药表现出典型的反应，现有的数据尚不确定。代替生化或药物基因组学参数，自定义的非洲血统似乎是个体对降压药反应的最佳预测因子。
Clinicians are encouraged to take an individualized approach when treating hypertension in patients of African ancestry, but little is known about why the individual patient may respond well to calcium blockers and diuretics, but generally has an attenuated response to drugs inhibiting the renin-angiotensin system and to β-adrenergic blockers. Therefore, we systematically reviewed the factors associated with the differential drug response of patients of African ancestry to antihypertensive drug therapy. Using the methodology of the systematic reviews narrative synthesis approach, we sought for published or unpublished studies that could explain the differential clinical efficacy of antihypertensive drugs in patients of African ancestry. PUBMED, EMBASE, LILACS, African Index Medicus and the Food and Drug Administration and European Medicines Agency databases were searched without language restriction from their inception through June 2012. We retrieved 3,763 papers, and included 72 reports that mainly considered the 4 major classes of antihypertensive drugs, calcium blockers, diuretics, drugs that interfere with the renin-angiotensin system and β-adrenergic blockers. Pharmacokinetics, plasma renin and genetic polymorphisms did not well predict the response of patients of African ancestry to antihypertensive drugs. An emerging view that low nitric oxide and high creatine kinase may explain individual responses to antihypertensive drugs unites previous observations, but currently clinical data are very limited. Available data are inconclusive regarding why patients of African ancestry display the typical response to antihypertensive drugs. In lieu of biochemical or pharmacogenomic parameters, self-defined African ancestry seems the best available predictor of individual responses to antihypertensive drugs.
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DOI：
10.1016/s0735-1097(03)00054-8
发表时间：
2003-04-02
影响因子：
24
作者：
Flack, JM;Oparil, S;Saunders, E
通讯作者：
Saunders, E
影响因子：
5.9
作者：
FREIS, ED;MATERSON, BJ;FLAMENBAUM, W
通讯作者：
FLAMENBAUM, W
影响因子：
3.2
作者：
Canzanello, Vincent J.;Baranco-Pryor, Evelyn;Chapman, Arlene B.
通讯作者：
Chapman, Arlene B.
影响因子：
37.8
作者：
Ford, Earl S.
通讯作者：
Ford, Earl S.
影响因子：
4.9
作者：
Bhatnagar, Vibha;O'Connor, Daniel T.;Lipkowitz, Michael S.
通讯作者：
Lipkowitz, Michael S.