Clinical experience with perindopril in African-American hypertensive patients: a large United States community trial

Abstract Background The prevalence of hypertension is greater in African Americans, and management of this condition presents challenges for practicing physicians. Methods The effectiveness and safety of perindopril was evaluated in hypertensive African-American patients (n = 1412) and hypertensive white patients (n = 7745) who had participated in a large United States community trial. Patients received perindopril 4 mg once daily for 6 weeks. Based on physiciansʹ clinical judgment at week 6, the dose was either maintained or increased to 8 mg for an additional 6 weeks. Results Reduction of blood pressure (BP) was significant with perindopril monotherapy (4 to 8 mg once daily) in African Americans and whites (P< .001). The magnitude of BP reduction was significantly more in whites (P< .001). Up-titration of perindopril achieved additional BP reduction in both ethnic groups (P< .001). Control of BP (<140/90 mm Hg) in elderly (>65 years of age) and diabetic African-Americans subgroups was achieved in 32.1% and 31.6%, respectively. Perindopril was safe and well tolerated. Conclusions Perindopril monotherapy is effective and is a viable initial therapeutic option as an antihypertensive agent in African-American individuals with hypertension.