Universidade Federal de São João Del-Rei - Campus Centro-Oeste Dona Lindu, Divinópolis, MG - Brasil.
Universidade Federal de Minas Gerais - Faculdade de Medicina e Hospital das Clínicas, Belo Horizonte, MG - Brasil.
Arq Bras Cardiol. 2022 Mar;118(3):614-622. doi: 10.36660/abc.20201180.
It seems that the worst response to some classes of antihypertensive drugs, especially angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, on the part of the Black population, would at least partially explain the worse control of hypertension among these individuals. However, most of the evidence comes from American studies.
This study aims to investigate the association between self-reported race/skin color and BP control in participants of the Longitudinal Study of Adult Health (ELSA-Brasil), using different classes of antihypertensive drugs in monotherapy.
The study involved a cross-sectional analysis, carried out with participants from the baseline of ELSA-Brasil. Blood pressure control was the response variable, participants with BP values ≥140/90 mmHg were considered out of control in relation to blood pressure levels. Race/skin color was self-reported (White, Brown, Black). All participants were asked about the continuous use of medication. Association between BP control and race/skin color was estimated through logistic regression. The level of significance adopted in this study was of 5%.
Of the total of 1,795 users of antihypertensive drugs in monotherapy at baseline, 55.5% declared themselves White, 27.9% Brown, and 16.7% Black. Even after adjusting for confounding variables, Blacks using angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blocker (ARB), thiazide diuretics (thiazide DIU), and beta-blockers (BB) in monotherapy had worse blood pressure control compared to Whites.
Our results suggest that in this sample of Brazilian adults using antihypertensive drugs in monotherapy, the differences in blood pressure control between different racial groups are not explained by the possible lower effectiveness of ACEIs and ARBs in Black individuals.
似乎在黑人人群中，某些类别的降压药（尤其是血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂）的反应最差，这至少部分解释了这些人群中高血压控制较差的原因。然而，大多数证据来自美国的研究。
本研究旨在通过单药治疗不同类别的降压药，调查纵向成人健康研究（ELSA-Brasil）参与者中自我报告的种族/肤色与血压控制之间的关联。
本研究为横断面分析，涉及 ELSA-Brasil 的基线参与者。血压控制是因变量，血压值≥140/90mmHg 的参与者被认为血压控制不理想。种族/肤色为自我报告（白种人、棕种人、黑种人）。所有参与者均被问及连续用药情况。通过逻辑回归估计血压控制与种族/肤色之间的关联。本研究采用的显著性水平为 5%。
在基线时使用单药降压药的 1795 名患者中，55.5%自我报告为白种人，27.9%为棕种人，16.7%为黑种人。即使在调整了混杂变量后，与白种人相比，使用血管紧张素转换酶抑制剂（ACEI）、血管紧张素受体阻滞剂（ARB）、噻嗪类利尿剂（噻嗪 DIU）和β受体阻滞剂（BB）的黑人单药治疗患者血压控制更差。
我们的研究结果表明，在本巴西成年人使用单药降压药的样本中，不同种族人群之间血压控制的差异不能用 ACEI 和 ARB 在黑人个体中的可能较低疗效来解释。
