SynthesisBMC nephrology2013
Difference in blood pressure response to ACE-Inhibitor monotherapy between black and white adults with arterial hypertension: a meta-analysis of 13 clinical trials.
Synthesis in BMC nephrology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Suboptimal blood pressure control and its associated factors among people living with diabetes mellitus in sub-Saharan Africa: a systematic review and meta-analysis.Systematic reviews · 2022Pooled it
- The Effects of Oral Taurine on Resting Blood Pressure in Humans: a Meta-Analysis.Current hypertension reports · 2018Pooled it
- Renin-Angiotensin System Inhibitors vs Other Antihypertensives in Hypertensive Blacks: A Meta-Analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2017Pooled it
- Angiotensin II receptor blocker attenuates stress pressor response in young adult African Americans.Journal of clinical hypertension (Greenwich, Conn.) · 2019Trial
- Short-term effects of perindopril-amlodipine vs perindopril-indapamide on blood pressure control in sub-Saharan type 2 diabetic individuals newly diagnosed for hypertension: A double-blinded randomized controlled trial.Journal of clinical hypertension (Greenwich, Conn.) · 2019Trial
- Evaluation of the angiotensin II receptor blocker azilsartan medoxomil in African-American patients with hypertension.Journal of clinical hypertension (Greenwich, Conn.) · 2017Trial
- Are Angiotensin-Converting Enzyme Inhibitors Effective in the Treatment of Hypertension in Black Patients?CJC open · 2026Review
- Comparative Effectiveness of ACE Inhibitors and Angiotensin Receptor Blockers for Cardiovascular Disease Prevention in People Living with HIV and Hypertension.medRxiv : the preprint server for health sciences · 2026Article
- Efficacy and safety of selective aldosterone synthase inhibitors in uncontrolled hypertension: a systematic review and meta-analysis of randomized controlled trials.Clinical hypertension · 2025Review
- Article
- Analysis of the combined effect of rs699 and rs5051 on angiotensinogen expression and hypertension.Chronic diseases and translational medicine · 2024Article
- Is the response to antihypertensive drugs heterogeneous? Rationale for personalized approach.European heart journal supplements : journal of the European Society of Cardiology · 2024Article
- Genetic heterogeneity in cardiovascular disease across ancestries: Insights for mechanisms and therapeutic intervention.Cambridge prisms. Precision medicine · 2023Review
- Evaluating a tool to improve engagement and recruitment of under-served groups in trials.Trials · 2022Article
- Racial Differences in Blood Pressure Control from Users of Antihypertensive Monotherapy: Results from the ELSA-Brasil Study.Arquivos brasileiros de cardiologia · 2022Article
- Article
- Article
- Antihypertensive agents: a long way to safe drug prescribing in children.Pediatric nephrology (Berlin, Germany) · 2020Review
- Association of West African ancestry and blood pressure control among African Americans taking antihypertensive medication in the Jackson Heart Study.Journal of clinical hypertension (Greenwich, Conn.) · 2020Article
- Rationale and design of a multicenter Chronic Kidney Disease (CKD) and at-risk for CKD electronic health records-based registry: CURE-CKD.BMC nephrology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundAmong African-Americans adults, arterial hypertension is both more prevalent and associated with more complications than among white adults. Hypertension is also epidemic among black adults in sub-Saharan Africa. The treatment of hypertension among black adults may be complicated by lesser response to certain classes of anti-hypertensive agents.
methodsWe systematically searched literature for clinical trials of ACE-inhibitors among hypertensive adults comparing blood pressure response between whites and blacks. Meta-analysis was performed to determine the difference in systolic and diastolic blood pressure response. Further analysis including meta-regressions, funnel plots, and one-study-removed analyses were performed to investigate possible sources of heterogeneity or bias.
resultsIn a meta-analysis of 13 trials providing 17 different patient groups for evaluation, black race was associated with a lesser reduction in systolic (mean difference: 4.6 mmHg (95% CI 3.5-5.7)) and diastolic (mean difference: 2.8 mmHg (95% CI 2.2-3.5)) blood pressure response to ACE-inhibitors, with little heterogeneity. Meta-regression revealed only ACE-inhibitor dosage as a significant source of heterogeneity. There was little evidence of publication bias.
conclusionsBlack race is consistently associated with a clinically significant lesser reduction in both systolic and diastolic blood pressure to ACE-inhibitor therapy in clinical trials in the USA and Europe. In black adults requiring monotherapy for uncomplicated hypertension, drugs other than ACE-inhibitors may be preferred, though the proven benefits of ACE-inhibitors in some sub-groups and the large overlap of response between blacks and whites must be remembered. These data are particularly important for interpretation of clinical drug trials for hypertensive black adults in sub-Saharan Africa and for the development of treatment recommendations in this population.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.