[Treating black hypertensive patients: limited applicability of the guideline recommendations].

Autor: Bakkum MJ; Amsterdam UMC, locatie VUmc, afd. Interne Geneeskunde,Amsterdam.; Contact: M. J. Bakkum (m.bakkum@amsterdamumc.nl)., Muntinga ME; Amsterdam UMC, locatie VUmc, afd. Ethiek, Recht en Humaniora,Amsterdam., Verdonk P; Amsterdam UMC, locatie VUmc, afd. Ethiek, Recht en Humaniora,Amsterdam., Tichelaar J; Amsterdam UMC, locatie VUmc, afd. Interne Geneeskunde,Amsterdam.
Jazyk: Dutch; Flemish
Zdroj: Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2021 Apr 15; Vol. 165. Date of Electronic Publication: 2021 Apr 15.
Abstrakt: Self-identified black patients respond better to calcium channel blockers and diuretics, than to renin-angiotensin-system inhibiting agents. This has been translated into sensitive guideline recommendations to treat black patients differently than others. We argue that such recommendations have limited applicability. Studies that shaped these recommendations selected patients on the basis that they self-identify as Black. This self-identification is often considered synonymous to having an African ancestry, but ancestry is but one of the many factors that constitutes one's self-identification. Moreover, if any, the African roots of these patients are often many generations old. Patients that self-identify as Black are likely to have ancestors from other races that co-determine their response to antihypertensive medications. The ancestry of black Dutch patients is diverse, and incomparable to black American or African patients. Therefore it is ill-advised to treat Dutch patients based on associations found in these populations. Studies in more comparable populations are scarce and contradictory.
Databáze: MEDLINE