Medicine: new heart pill for blacks only?
There's a great myth in medicine that African Americans don't respond well to hypertension medications, specifically Ace-inhibitors. Well, it's sorta true--you might have to use a higher dose or an adjunct drug to get the numbers where they're supposed to be. But the pharmacology of these drugs has anything but directly caused the prejudices physicians use in prescribing hypertension meds for African Americans. Bottom line: docs should prescribe to the numbers, not to the race.
Now we have a company marketing their drug, a combination of isosorbide dinitrate and hydralazine, thought to affect nitrous oxide pathways (and useless on their own), exclusively for African Americans--in fact, their clinical trials ONLY tested the drug on African Americans, which is a nice change of pace in the white-centric world of medicine, but its more of a business move than any sort of nice political thought.
The scariest part might be that physicians could easily start treating this as the "black pill." And that sort of short-cut is bound to lead to some dangerous practice of medicine.
2 comments:
Although I agree with what you are saying, I would have to disagree with your "bottom line" stating that "docs should prescribe by the numbers, not to the race." My bottom line is that Docs should prescribe for the person, not just by the numbers or to the race. You HAVE to look at the numbers, but you must also consider the person. Sometimes age, race, and other subjective findings play key roles in determining an appropriate drug therapy. However, I do agree (very much so) with what you are saying in your post. Just wanted to put in my two denarii. Also, i wanted to play an active role in your totally cool blog.
P.S. To letters that would follow sequentially if there was no Q an R. This is matthew k. by the way.
Welcome Keib.
Well I of course agree that the underlying treatment is to the person, but as an objective in the control of their hypertension, the numbers are the goal. This goal is of course always secondary to treatment of the whole individual, and I don't think you're distinction is at all picky. I second-guessed myself when I phrased that the first time, and you're quite right to correct it. But point being, Ace-inhibitors most certainly can be part of an effective drug regimen for controlling hypertension in anybody, and using race as a blanket director of treatment is SCARY. 120/80 is race-independent, and blood pressure control is probably one of the most mechanistic things we can do as doctors for our patients' wellbeing. And we suck at it. And there's no excuse for that.
Post a Comment