Common hypertension drugs have been linked to significantly worse cardiovascular outcomes in African Americans vs. whites, a new study conducted by researchers at NYU Langone Medical Center have reported. Findings from the study are published in the Journal of the American College of Cardiology.

The study compared racial differences in cardiovascular outcomes and mortality between black and white patients with hypertension who were initiated on angiotensin-converting enzyme (ACE) inhibitors, outside of a clinical trial. Researchers used data from electronic health records of close to 60,000 patients with high blood pressure that received care between 2004–2009 within New York City’s Health and Hospital Corporation. The team looked at rates of all-cause mortality, heart attack, stroke, and congestive heart failure among black and white patients who were given one of four antihypertensives: ACE inhibitors, beta-blockers, calcium-channel blockers, or thiazide-type diuretics.

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For African Americans, use of ACE inhibitors was linked to a statistically significant rate of poorer cardiovascular outcomes (8.7% vs. 7.7%) but not in whites (6.4% vs. 6.74%). However, African Americans were not more likely to have adverse effects from use of ACE inhibitors than whites.

Reasons for the difference in clinical efficacy of ACE inhibitor-based regimens for African Americans and whites are not definitive, researchers conclude, but it may be because blacks are less responsive to treatment with ACE inhibitors and are also at increased risk for cardiovascular events than their white counterparts. Study findings support the general physicians’ consensus that black patients should not be initiated with ACE inhibitors.

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