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(Circulation. 2001;103:e9040.)
© 2001 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH, Circulation Newswriter

Racial Differences in Response to Drug for Heart Failure Spark Debate

Two studies in the May 3, 2001, issue of the New England Journal of Medicine show that blacks respond differently to drugs commonly used to treat forms of heart failure. However, 2 editorialists debate the significance of these findings in companion opinion pieces.

One article evaluated the use of ACE inhibitors in patients with heart failure by analyzing data from the Studies of Left Ventricular Dysfunction (SOLVD) prevention and treatment trials (N Engl J Med. 2001;344:1351–1357). These 2 large, randomized studies compared the ACE inhibitor enalapril with placebo in patients with left ventricular dysfunction.

The US and Canadian researchers, who were led by Derek V. Exner, MD, of the University of Calgary, used a matched cohort design in which 4 white patients were matched with each black patient according to trial, treatment assignment, sex, left ventricular ejection fraction, and age. A total of 1196 white patients were matched with 800 black patients. Although the patients had similar demographic and clinical characteristics, the black patients had higher rates of death from any cause (12.2 versus 9.7 per 100 person-years) and of hospitalizations for heart failure (13.2 versus 7.7 per 100 person-years). Enalapril therapy resulted in a 44% reduction in the risk of hospitalization among the white patients, but there was no significant reduction in the risk of hospitalization among black patients. After 1 year of therapy, white patients but not black patients had a significant reduction in systolic blood pressure. Neither group had a significant change in the risk . . . [Full Text of this Article]