Efficacy and tolerability of eplerenone and losartan in hypertensive black and white patients

Ethnic Differences in Cardiovascular Drug Response

“…In comparisons between groups, blacks respond slightly better than whites to diuretics and CCBs, while whites respond slightly better than blacks to ACE inhibitors and β-blockers. More recent data on lisinopril, quinapril and losartan support the differences with ACE inhibitors and ARBs suggested by the meta-analysis 36-38…”

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.…”

Eplerenone

“…Increases serum aldosterone and plasma renin levels; [19][20][21][22] but this does not overcome the antihypertensive effects [14,19] Causes natriuresis with increased sodium excretion and decreased potassium excretion [12,23] Reduces vascular/myocardial fibrosis and cardiac hypertrophy in animal models of cardiac injury, possibly independently of effects on BP [16,[24][25][26] Improves endothelial dysfunction and attenuates the effects of vasoactive mediators on vascular endothelium in rodent/rabbit models [15,27,28] Increases vascular compliance in patients with hypertension [29] Reduces left ventricular mass in patients with hypertension and left ventricular hypertrophy [30] Reduces proteinuria in patients with hypertension [29][30][31][32][33] reduced free radical stress in a rabbit model of diet-induced atherosclerosis [27] (see also section 2.4.2). affinities 5.1 × 10 -3 vs 1.1 × 10 -1 ).…”

“…hypertension [30][31][32][33]42] (see section 4.3.2 for details). As would be expected given their different mechanisms of…”