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document
Gender difference in the response to an angiotensin-converting enzyme inhibitor and a diuretic in hypertensive patients of African descent . BACKGROUND The efficacy of angiotensin-converting enzyme ( ACE ) inhibitors in decreasing blood pressure in African patients is controversial . OBJECTIVE We examined the ambulatory blood pressure ( ABP ) response to a diuretic and an ACE inhibitor in hypertensive patients of East African descent and evaluated the individual characteristics that determined treatment efficacy . DESIGN A single-blind randomized AB/BA crossover design . SETTING Hypertensive families of East African descent from the general population in the Seychelles . PARTICIPANTS Fifty-two ( 29 men and 23 women ) out of 62 eligible hypertensive patients were included.Main outcome measures ABP response to 20 mg lisinopril ( LIS ) daily and 25 mg hydrochlorothiazide ( HCT ) daily given for a 4-week period . Results The daytime systolic/diastolic ABP response to HCT was 4.9 [ 95 % confidence interval ( CI ) 1.2-8.6 ] /3.6 ( 1.0-6.2 ) mmHg for men and 12.9 ( 9.2-16.6 ) /6.3 ( 3.7-8.8 ) mmHg for women . With LIS the response was 18.8 ( 15.0-22.5 ) /14.6 ( 12.0-17.1 ) mmHg for men and 12.4 ( 8.7-16.2 ) /7.7 ( 5.1-10.2 ) mmHg for women . The night-time systolic/diastolic response to HCT was 5.0 ( 0.6-9.4 ) /2.7 [ ( -0.4 ) -5.7 ] mmHg for men and 11.5 ( 7.1-16.0 ) /5.7 ( 2.6-8.8 ) mmHg for women , and to LIS was 18.7 ( 14.2-22.1 ) /15.4 ( 12.4-18.5 ) mmHg for men and 3.5 [ ( -1.0 ) -7.9 ] /2.3 [ ( -0.8 ) -5.4 ] mmHg for women . Linear regression analyses showed that gender is an independent predictor of the ABP responses to HCT and to LIS . CONCLUSIONS Hypertensive patients of African descent responded better to LIS than to HCT . Men responded better to LIS than to HCT and women responded similarly to both drugs .
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Intervention_Pharmacological
angiotensin-converting enzyme inhibitor
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Intervention_Pharmacological
diuretic
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Intervention_Pharmacological
angiotensin-converting enzyme ( ACE ) inhibitors
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Intervention_Pharmacological
diuretic
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Intervention_Pharmacological
ACE inhibitor
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Intervention_Pharmacological
lisinopril ( LIS )
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Intervention_Pharmacological
hydrochlorothiazide ( HCT )
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Intervention_Pharmacological
HCT
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Intervention_Pharmacological
LIS
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Intervention_Pharmacological
HCT
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Intervention_Pharmacological
LIS
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Intervention_Pharmacological
LIS
17110
Intervention_Pharmacological
HCT
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Intervention_Pharmacological
HCT
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Outcome_Physical
decreasing blood pressure
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Outcome_Physical
ambulatory blood pressure ( ABP ) response
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Outcome_Physical
characteristics
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Outcome_Other
treatment efficacy
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Outcome_Physical
ABP response
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Outcome_Physical
daytime systolic/diastolic ABP response
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Outcome_Physical
night-time systolic/diastolic response
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Outcome_Other
gender is an independent predictor of the ABP responses
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Outcome_Mental
Men responded better
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Outcome_Mental
women responded similarly
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Participant_Condition
hypertensive patients of African descent
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Participant_Sample-size
Fifty-two
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Participant_Sample-size
29
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Participant_Sex
men
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Participant_Sample-size
23
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Participant_Sex
women