Mon Sep 16 14:00:00 UTC 2024: ## UK Hypertension Guidelines Questioned: New Research Shows Ethnic Differences in Drug Effectiveness

**London, UK** – A new study published in PLOS Medicine challenges the current UK guidelines recommending angiotensin receptor blockers (ARBs) over angiotensin-converting enzyme inhibitors (ACEIs) for Black patients with hypertension. The research, conducted by a team from the London School of Hygiene & Tropical Medicine and McMaster University, analyzed data from over 573,000 patients in England, revealing significant differences in drug effectiveness across ethnic groups.

The study, which emulated the design of the landmark ONTARGET trial, found that while ARBs and ACEIs were generally equally effective in preventing cardiovascular events, there were distinct ethnic variations. Notably, Black patients treated with ARBs experienced a higher risk of cardiovascular death compared to those on ACEIs, while White patients saw a lower risk. South Asian patients showed no significant differences in outcomes between the two drug types.

The study also explored the risk of angioedema, a potentially serious side effect associated with ACEI use. While overall, ARBs were associated with a lower risk of angioedema, the researchers found a higher incidence among Black patients compared to White or South Asian patients. This disparity suggests that current guidelines may not be optimal for Black patients, potentially leading to adverse consequences.

“Our findings indicate that the current UK hypertension guidelines, which recommend an ARB in preference to an ACEi for Black individuals, may not be the most appropriate approach for this specific group,” said lead author Dr. Paris Baptiste. “We observed a higher risk of cardiovascular death associated with ARB use in Black individuals, highlighting the importance of considering ethnic variations in drug effectiveness.”

The study’s authors emphasize the need for further research, particularly large-scale randomized trials, to confirm these findings and develop more tailored treatment strategies for different ethnic groups. They also highlight the importance of diversifying clinical trials to ensure that research findings are relevant and applicable to all populations.

This research serves as a crucial reminder that clinical guidelines should not be universally applied without considering potential ethnic variations in drug efficacy and safety. It calls for a reevaluation of current recommendations and a continued focus on developing evidence-based guidelines that cater to the unique needs of different ethnic groups.

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