Ethnic Differences in Response to β1Adrenoceptor Blockade by Propranolol

Why do hypertensive patients of African ancestry respond better to calciumblockers and diuretics than to ACE inhibitors and β-adrenergic blockers? Asystematic review

“…The design of the included studies varied, from observational studies to small and large scale clinical trials, in subjects of sub-Saharan African descent, studied within Africa (Nigeria [46,59,67], Kenya [64], and South Africa [26,61,62,69,78]), or in the African diaspora (the Netherlands, persons from Suriname, the Dutch Antilles, and Ghana [12,72,73]; United Kingdom, persons from Nigeria [54,60], Sierra Leone [54], Zimbabwe [54], Zambia [54], Tanzania [54], or country of origin not stated [50]; all other were in the United States, except for one paper that did not state the location of the study [34]). Ethno-geographic origin was either self-defined, or defined by the authors of the reports, in the participants being of European or African ancestry.…”

“…While early studies found a reduced sensitivity to isoprenaline in healthy men of African ancestry [49], reports on changes in heart rate after β-blockers in healthy volunteers were conflicting, with either a greater response in persons of African ancestry (to oral propranolol 240 mg/d); [75] an attenuated response (to intravenous propranolol up to 0.15 mg/kg [78], or metoprolol 50 μg/mL); [55] or no significant difference between groups (to intravenous propranolol 0.15 mg/kg) [49]. We retrieved no studies in hypertensives.…”

A need for greater reporting of socioeconomic status and race in clinical trials

“…[21][22][23][24][25] Furthermore, race can influence the efficacy profile of various therapeutic agents. [26][27][28][29] Some of the hypotheses to explain these racial differences in the prevalence of disease and the response to treatment have included genetic polymorphisms, differences in SES, and disparities in healthcare use. A better understanding of the role of race on treatment modalities will require inclusion and reporting of race in clinical studies along with subgroup analysis by race.…”

Comparative Efficacy of Timolol and Latanoprost on Intraocular Hypertension Among Patients Attending the Ophthalmic Clinic of Irrua Specialist Teaching Hospital, Irrua, Nigeria

“…On the other hand,IOP reducing potentials have also been reported for prostaglandin analogues too [13][14][15][16]. Various studies have demonstrated the efficacy and safety of the common topical beta adrenergic antagonists and prostaglandin analogues in reducing lOP, however, they are not as effective in Africans as they are in Caucasians [17][18][19][20][21]. The implication is that there is variation in the IOP response of these drugs.…”