USE OF BETA-ADRENERGIC-RECEPTOR BLOCKERS IN BLACKS

Beta adrenergic receptor blockers (beta-blockers) are an important cla ss of drugs in the management of patients with cardiovascular diseases . These drugs have been shown to reduce mortality in hypertension and prolong survival in patients with coronary heart disease. Although hyp ertension and coronary heart disease account for the majority of exces s cardiovascular morbidity and mortality in blacks, beta-blockers cont inue to be underprescribed in this ethnic group. The magnitude of bloo d pressure reduction in black patients with hypertension has been cons istently less during monotherapy with nonselective beta-blockers than with diuretics. However, the highly selective beta-blocker bisoprolol has been shown to be as effective as diuretics and is equally effectiv e in black and nonblack patients with hypertension. In general, no rac ial differences in efficacy are noted when beta-blockers are used with diuretics as combination therapy for hypertension. Black patients sho uld not be denied beta-blocker therapy because of an anticipated subop timal response, especially when there ore clear indications for treatm ent (e.g., for migraine, hyperthyroidism, arrhythmia control, and afte r myocardial infarction).