The efficacy of beta-adrenoceptor and calcium-entry blockers in hypertensive blacks.

The data on treatment of hypertension in black patients with beta-adrenoceptor blockers (BB) or calcium-entry blockers (CEB) have been reviewed. There is much evidence that in monotherapy BB are no better than inert placebo for the majority of hypertensive black patients. Their hypotensive action in blacks is less than that induced by other antihypertensive agents, mainly diuretics. Comparative evaluation of the responsiveness of blacks, whites, and Indians to BB therapy showed a poorer control of blood pressure (BP) among blacks than among nonblacks. However, when combined with diuretic therapy, BBs are equipotent in blacks and whites. The reasons for the hyporesponsiveness of black patients to BB therapy are not fully understood. On the other hand, CEBs appear to be as efficacious as diuretic therapy in hypertensive blacks. In addition, they lower blood pressure to the same extent in black and white patients. They are also proven to be effective adjunctive therapy to diuretics for hypertension in blacks. The reason for the better responsiveness of blacks to CEB therapy might include the severity of hypertension in blacks, their low plasma renin, their blunted sympathetic activity, and their high intracellular sodium concentration.