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Senior Citizen Health & Medicine
Hispanic Women Respond Better to High Blood Pressure
Drugs than Non-Hispanic Whites
Half as likely, too, as white women to suffer adverse
outcomes
 July 13, 2007 - Hispanic women with hypertension
and coronary artery disease respond better to drug treatment aimed at
controlling high blood pressure than non-Hispanic white women,
University of Florida researchers report. Hypertension is the most
common chronic disease among senior citizens and rapidly increasing in
women, although it is estimated that it is less common among Hispanics.
A UF study described in the current issue of the
Journal of Womens Health revealed that when treated with either of two
commonly prescribed medication strategies, Hispanic women achieved
greater blood pressure control and were half as likely as white women to
suffer adverse outcomes such as heart attack, stroke or death from any
cause.
The findings provide new data on a population of
ethnic women who have been all but absent from such research.
The study is unique in that we enrolled a
substantial number of women and a substantial number of Hispanic
patients from a variety of different Hispanic regions. As a result, we
have data that enabled us to really fully evaluate the treatment of
hypertension in this ethnically diverse group, said Rhonda Cooper-DeHoff,
Pharm.D, M.S., a research assistant professor of medicine and associate
director of the clinical research program in cardiovascular medicine at
UFs College of Medicine.
UF researchers studied 22,500 patients enrolled in
the landmark International Verapamil SR-Trandolapril study, known as
INVEST, and tracked a subgroup of 5,017 Hispanic and 4,710 non-Hispanic
white women who were randomly assigned to a drug strategy containing
either a sustained release form of the calcium antagonist verapamil or
the beta-blocker atenolol.
The INVEST study enrolled more Hispanic patients
than any other hypertension trial to date, Cooper-DeHoff said, and
included Hispanic participants from the mainland United States, Puerto
Rico, Cuba, Mexico, Canada, Guatemala, Panama and El Salvador.
After 24 months of follow-up, researchers found
that both treatment strategies worked and worked better in the
Hispanic women.
Blood pressure control, defined at less than 140/90
mmHg, was achieved in 75 percent of Hispanic women and 68 percent of
non-Hispanic white women.
And despite having a higher prevalence of diabetes
at baseline, only 5.7 percent of Hispanic women suffered from adverse
cardiovascular outcomes, compared with 12.3 percent of non-Hispanic
white women.
Cooper-DeHoff attributed the low incidence of
adverse outcomes to the fact that Hispanic women enrolled in the study
were younger. If follow-up had continued over a longer period of time,
adverse outcomes in the Hispanic women may have increased, she said.
However, these women remained at a lower risk for
these outcomes even after statisticians adjusted for age and other
factors. Still, she warned that problems associated with diabetes are
likely to show up in these patients down the road.
Diabetes in and of itself imparts significant
future adverse cardiovascular outcomes, she said.
These women should be well-monitored under the
care of a physician so that they can prevent future cardiovascular
morbidity and mortality related to hypertension and diabetes.
Importantly, because the Hispanic population is the fastest-growing
ethnic minority in the United States, Hispanics especially women
should be included in future cardiovascular research in order to further
our understanding of these high-risk diseases in Hispanic patients.
High blood pressure is becoming more prevalent in
women across all ethnic groups, Cooper-DeHoff said. And although it is
thought to actually be less common in Hispanic women, fewer Hispanics
have been included in hypertension studies.
The INVEST findings are important because they
demonstrate that this treatment for Hispanic women really pays off,
said Thomas G. Pickering, M.D., D. Phil., director of the Center for
Behavioral Cardiovascular Health at Columbia University Medical Center.
Theyve got something really interesting with this study, and it wasnt
something that could have been expected.
About High Blood Pressure from National Heart, Lung
and Blood Institute
Who Is At Risk for High Blood Pressure?
About 65 million American adultsnearly 1 in 3have
high blood pressure.
In the United States, high blood pressure occurs
more often in African Americans than in Caucasians. Compared to other
groups, African Americans:
● Tend to get high blood pressure earlier in life
● Usually have more severe high blood pressure
● Have a higher death rate from stroke, heart
disease, and kidney failure
Many people get high blood pressure as they get
older. Over half of all Americans aged 60 and older have high blood
pressure. This is not a part of healthy aging! There are things you can
do to help keep your blood pressure normal, such as eating a healthy
diet, maintaining a healthy weight, and getting enough physical
activity.
Your chances of developing high blood pressure are
also higher if you:
● Are overweight
● Are a man over the age of 45
● Are a woman over the age of 55
● Have a family history of high blood pressure
● Have prehypertension (that is, blood pressure
in the 120139/8089 mmHg range)
Other things that can raise blood pressure include:
● Eating too much salt
● Drinking too much alcohol
● Not getting enough potassium in your diet
● Not doing enough physical activity
● Taking certain medicines
● Having long-lasting stress
● Smoking (smoking can cause a temporary rise in
blood pressure)
What Is High Blood Pressure?
High blood pressure is a blood pressure reading of
140/90 mmHg or higher. Both numbers are important.
Nearly 1 in 3 American adults has high blood
pressure. Once high blood pressure develops, it usually lasts a
lifetime. The good news is that it can be treated and controlled.
High blood pressure is called the silent killer
because it usually has no symptoms. Some people may not find out they
have it until they have trouble with their heart, brain, or kidneys.
When high blood pressure is not found and treated, it can cause:
● The heart to get larger, which may lead to
heart failure.
● Small bulges (aneurysms (AN-u-risms)) to form
in blood vessels. Common locations are the main artery from the heart
(aorta); arteries in the brain, legs, and intestines; and the artery
leading to the spleen.
● Blood vessels in the kidney to narrow, which
may cause kidney failure.
● Arteries throughout the body to "harden"
faster, especially those in the heart, brain, kidneys, and legs. This
can cause a heart attack, stroke, kidney failure, or amputation of part
of the leg.
● Blood vessels in the eyes to burst or bleed,
which may cause vision changes and can result in blindness.
What Is Blood Pressure?
Blood is carried from the heart to all parts of
your body in vessels called arteries. Blood pressure is the force of the
blood pushing against the walls of the arteries. Each time the heart
beats (about 6070 times a minute at rest), it pumps out blood into the
arteries. Your blood pressure is at its highest when the heart beats,
pumping the blood. This is called systolic (sis-TOL-ik) pressure. When
the heart is at rest, between beats, your blood pressure falls. This is
the diastolic (di-a-STOL-ik) pressure.
Blood pressure is always given as these two
numbers, the systolic and diastolic pressures. Both are important.
Usually they are written one above or before the other, such as 120/80
mmHg (measured in millimeters of mercury, a unit for measuring
pressure). When the two measurements are written down, the systolic
pressure is the first or top number, and the diastolic pressure is the
second or bottom number (for example, 120/80). If your blood pressure is
120/80, you say that it is "120 over 80."
Blood pressure changes during the day. It is lowest
as you sleep and rises when you get up. It also can rise when you are
excited, nervous, or active.
Still, for most of your waking hours, your blood
pressure stays pretty much the same when you are sitting or standing
still. That level should be lower than 120/80 mmHg. When the level stays
high, 140/90 mmHg or higher, you have high blood pressure. With high
blood pressure, the heart works harder, your arteries take a beating,
and your chances of a stroke, heart attack, and kidney problems are
greater.
What Is Normal Blood Pressure?
A blood pressure reading below 120/80 mmHg is
considered normal. In general, lower is better. However, very low blood
pressure can sometimes be a cause for concern and should be checked out
by a doctor.
More information at
http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_WhatIs.html
Additional information about treatments for
hypertension can be found at
www.fda.gov/fdac/features/1999/499_hbp.html.
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