Black Patients Not Prescribed Diuretics Enough

Photo: Measuring blood pressure

Many previous studies have shown that
diuretics are particularly helpful in black
patients with hypertension; © panther- Timm

The researchers say these new findings should be taken as a serious wake-up call for physicians who treat black patients with hypertension. Their study found that the patients in the study who used the common diuretic drugs had, on average, lower blood pressure (both systolic and diastolic) than the patients who did not receive them.

"We were surprised to find that this beneficial and low-cost drug was not being prescribed for more patients who would benefit from it," says the study's lead investigator, Doctor Linda Gerber.

Many previous studies have shown that diuretics are particularly helpful in black patients with hypertension and should be used as first or second-line treatment - findings that have been written into treatment guidelines. Also, several recent clinical trials have reported that newer classes of agents are not superior to the older diuretic agents, especially in blacks. Newer drugs for hypertension include angiotensin-converting enzyme inhibitors (ACEs), angiotensin-receptor blockers (ARBs) and calcium-channel blockers (CCBs).

"Yet, we find that physicians are not using the drugs as they should in a population that is especially hard hit by high blood pressure, and who suffer greater prevalence, severity, organ damage and mortality from the disease compared to other groups," says Gerber.
While Gerber did not speculate on why this phenomenon is occurring since doctors were not interviewed as part of this research, study co-author, Doctor Samuel Mann, has some theories.

"Guidelines are not rules and they are not enforceable, and some physicians may worry about potential side effects of diuretics - which, although not uncommon, are not a major problem. And in patients with uncontrolled hypertension, the benefit of treating with a diuretic far outweighs the risk of side effects that are generally very manageable," says Mann. "Also, newer drugs are promoted much more aggressively than diuretics. However, many studies show that diuretics work very well, particularly in black patients, so between their effectiveness and low cost, their use should be a no-brainer."; Source: Weill Cornell Medical College