Department of Physiology and Biophysics, Center for Computational Medicine, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216-4505, USA.
Vascular Biology Center, Medical College of Georgia, Augusta University, Augusta, GA, 30912-5563, USA.
Biol Sex Differ. 2019 May 9;10(1):24. doi: 10.1186/s13293-019-0238-6.
African Americans (AA) develop hypertension (HTN) at an earlier age, have a greater frequency and severity of HTN, and greater prevalence of uncontrolled HTN as compared to the white population. Mineralocorticoid antagonists have been shown to be very effective in treating uncontrolled HTN in both AA and white patients, but sex-specific responses are unclear.
We evaluated the sex-specific impact of mineralocorticoid antagonism in an AA population. An AA cohort (n = 1483) from the Genetic Epidemiology Network of Arteriopathy study was stratified based on sex and whether they were taking spironolactone, a mineralocorticoid antagonist, in their antihypertensive regimen.
As compared to AA women not prescribed a mineralocorticoid antagonist, AA women taking spironolactone (n = 9) had lower systolic and diastolic blood pressure despite having a similar number of antihypertensive medications. The proportion of AA women with uncontrolled HTN was significantly less for patients taking spironolactone than for patients not prescribed spironolactone. Interestingly, none of these associations were found in the AA males or in white females.
Our data suggests that spironolactone is particularly effective in reducing blood pressure and controlling HTN in AA women. Further research into the impact of this therapy in this underserved and understudied minority is warranted.
与白人相比，非裔美国人（AA）更早出现高血压（HTN），HTN 的发生频率和严重程度更高，且未得到控制的 HTN 更为普遍。已证实，醛固酮拮抗剂在治疗 AA 和白人患者的未控制 HTN 方面非常有效，但性别特异性反应尚不清楚。
我们评估了醛固酮拮抗作用在 AA 人群中的性别特异性影响。根据是否正在服用螺内酯（一种醛固酮拮抗剂）作为降压方案中的药物，将来自动脉病变遗传流行病学网络研究的 AA 队列（n=1483）分为性别亚组。
与未服用醛固酮拮抗剂的 AA 女性相比，服用螺内酯的 AA 女性（n=9）尽管服用的降压药物数量相同，但收缩压和舒张压均较低。服用螺内酯的 AA 女性中未控制 HTN 的比例明显低于未服用螺内酯的女性。有趣的是，这些相关性在 AA 男性或白人女性中均未发现。
我们的数据表明，螺内酯在降低 AA 女性的血压和控制 HTN 方面特别有效。需要进一步研究这种治疗方法在这个服务不足和研究不足的少数群体中的作用。
