Takeaway
- Antihypertensive medications perform about the same regardless of age or ethnicity.
- People over age 75 years may experience steeper BP reductions with calcium channel blockers (CCBs) vs angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs).
- A numeric difference in drug effects between Black and non-Black people without diabetes did not meet statistical significance.
Why this matters
- These authors were examining UK treatment recommendations that are based on age and ethnicity and say that these factors might not be the best drivers of drug choice.
- They suggest urinary protein loss as a possible criterion.
Key results
- They included data for 87,440 new ACEI/ARB users; 67,274 new CCB users; and 22,040 new thiazide users.
- Systolic BP changes did not differ significantly below or at/above an age threshold of 55 years for any of the drugs.
- Stratification by ethnicity (Black or non-Black) also revealed no significant differences.
- Patterns at 12 weeks persisted at 1 year.
- Findings for diastolic BP were similar.
- The one significant finding was a steeper systolic BP decrease in non-Black people age 75+ years taking CCBs vs ACEIs/ARBs.
Study design
- Observational cohort study in UK primary cares, January 1, 2007-December 31, 2017.
- Funding: Author funding cited.
Limitations
- Drugs may have been prescribed for nonhypertension indications.
- Observational, residual confounding likely.
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