Racial and Ethnic Disparities in Antihypertensive Medication Prescribing Patterns and Effectiveness.

Autor: Goleva SB; National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA., Williams A; National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA., Schlueter DJ; National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.; Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada., Keaton JM; National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA., Tran TC; National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA., Waxse BJ; National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA., Ferrara TM; National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA., Cassini T; National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.; Division of Medical Genetics and Genomic Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Mo H; National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.; Cohort Analytics Core, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA., Denny JC; National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.; All of Us Research Program, National Institutes of Health, Bethesda, Maryland, USA.
Jazyk: angličtina
Zdroj: Clinical pharmacology and therapeutics [Clin Pharmacol Ther] 2024 Jul 25. Date of Electronic Publication: 2024 Jul 25.
DOI: 10.1002/cpt.3360
Abstrakt: Variability in drug effectiveness and provider prescribing patterns have been reported in different racial and ethnic populations. We sought to evaluate antihypertensive drug effectiveness and prescribing patterns among self-identified Hispanic/Latino (Hispanic), Non-Hispanic Black (Black), and Non-Hispanic White (White) populations that enrolled in the NIH All of Us Research Program, a US longitudinal cohort. We employed a self-controlled case study method using electronic health record and survey data from 17,718 White, Hispanic, and Black participants who were diagnosed with essential hypertension and prescribed at least one of 19 commonly used antihypertensive medications. Effectiveness was determined by calculating the reduction in systolic blood pressure measurements after 28 or more days of drug exposure. Starting systolic blood pressure and effectiveness for each medication were compared for self-reported Black, Hispanic, and White participants using adjusted linear regressions. Black and Hispanic participants were started on antihypertensive medications at significantly higher SBP than White participants in 13 and 7 out of 19 medications, respectively. More Black participants were prescribed multiple antihypertensive medications (58.46%) than White (52.35%) or Hispanic (49.9%) participants. First-line HTN medications differed by race and ethnicity. Following the 2017 American College of Cardiology and the American Heart Association High Blood Pressure Guideline release, around 64% of Black participants were prescribed a recommended first-line antihypertensive drug compared with 76% of White and 82% of Hispanic participants. Effect sizes suggested that most antihypertensive drugs were less effective in Hispanic and Black, compared with White, participants, and statistical significance was reached in 6 out of 19 drugs. These results indicate that Black and Hispanic populations may benefit from earlier intervention and screening and highlight the potential benefits of personalizing first-line medications.
(Published 2024. This article is a U.S. Government work and is in the public domain in the USA. Clinical Pharmacology & Therapeutics published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)
Databáze: MEDLINE
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