Title : Comparative outcomes of antihypertensive therapy in black vs non-hispanic white patients with hypertension and cardiovascular disease
Abstract:
This retrospective, multicenter cohort study evaluated the comparative effectiveness of calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs), and thiazide diuretics in reducing cardiovascular events among hypertensive African American and non-Hispanic White populations. Using data from HCA Healthcare’s multicenter database (2016–2022), we analyzed over 6,000 adult patients with documented hypertension and cardiovascular comorbidities. Patients were stratified by race and first-line antihypertensive class. The primary endpoint was a composite of myocardial infarction, stroke, hospitalization for heart failure, or cardiovascular death. Among African American patients, CCBs and thiazide diuretics were more effective at reducing cardiovascular events compared to ACEI/ARBs. In contrast, ACEI/ARBs showed comparable effectiveness across both racial groups when combined with diuretics. This study supports current hypertension management guidelines emphasizing race-specific therapy and reinforces the need for individualized antihypertensive strategies to mitigate long-term cardiovascular risk.
