J Natl Med Assoc
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Randomized Controlled Trial Multicenter Study Comparative Study
Irbesartan/HCTZ fixed combinations in patients of different racial/ethnic groups with uncontrolled systolic blood pressure on monotherapy.
The IrbesartaN/hydroChlorothiazide (HCTZ) bLood pressUre reductionS In diVErse patient populations (INCLUSIVE) trial was a multicenter, prospective, open-label, single-arm study evaluating the efficacy and safety of irbesartan/HCTZ fixed combinations in patients > or = 18 years old with uncontrolled systolic blood pressure (SBP, 140-159 mmHg; 130-159 mmHg for type-2 diabetes mellitus patients) after > or = 4 weeks of antihypertensive monotherapy. This analysis focused on different racial/ethnic subgroups. Treatment was sequential: placebo (4-5 weeks), HCTZ 12.5 mg (two weeks), irbesartan/HCTZ 150/12.5 mg (eight weeks) and irbesartan/HCTZ 300/25 mg (eight weeks). ⋯ By week 18, 70% (95% CI, 66%, 74%) of Caucasian, 66% (95% CI, 59%, 74%) of African-American and 65% (95% CI, 57%, 74%) of Hispanic/Latino patients achieved dual SBP/DBP goal. Treatments appeared to be well tolerated. In conclusion, irbesartan/HCTZ treatment provided SBP/DBP goal attainment in approximately two-thirds of Caucasian, African-American and Hispanic/Latino patients with SBP uncontrolled on antihypertensive monotherapy.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Preparing African-American men in community primary care practices to decide whether or not to have prostate cancer screening.
This study was a randomized trial to test the impact of an informed decision-making intervention on prostate cancer screening use. ⋯ Prostate cancer screening use may be influenced by exposure to decision education and the influence of screening-related primary care practice factors.
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Results of several clinical trials have shown that verapamil is effective in reducing blood pressure (BP) in African Americans, a population at high risk for hypertension and target-organ damage. Nonetheless, adequate control of BP is perceived as difficult to achieve in this population. A post hoc analysis of data from the community-based CHRONO trial (Controlling Hypertension in the moRning with a ChrONO medication) was undertaken to assess racial/ethnic differences in the safety and efficacy of the Chronotherapeutic Oral Drug Absorption System (CODAS) formulation of verapamil in a real-world setting. ⋯ Of the 59.7% of African Americans who reached the target BP of <140/90 mmHg, 64% did so at the 200-mg dose. Response rates were not affected by gender, age or treatment history, and CODAS-verapamil was well tolerated in all ethnic/racial treatment groups. In a trial conducted in actual clinical practices, the CODAS formulation of verapamil was shown to be safe and effective in African Americans, Caucasians, Hispanics and Asians.
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Multicenter Study Comparative Study
Childhood-onset systemic lupus erythematosus: a comparative study of African Americans and Latin Americans.
This study compared the clinical and serologic features in two different ethnic groups of patients with childhood-onset systemic lupus erythematosus (SLE). One hundred seventy-one SLE patients comprised the study population; 61 (55 girls and 6 boys) were African American with age at onset of 13 +/- 2.9 years, and 110 (97 girls and 13 boys) were Latin American (Colombian) with age at onset of 13 +/- 3.2 years. ⋯ In addition, there was a higher frequency of anti-dsDNA, anti-Sm, anti-RNP, and anti-Ro positivity among African-Americans compared with Latin-American patients. These results suggest the presence of ethnic differences in the clinical expression of SLE.
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Multicenter Study Comparative Study
Cancer rate differentials between blacks and whites in three metropolitan areas: a 10-year comparison.
This article compares cancer rate differentials for 1989-1993 and 1979-1981 between black and whites in Los Angeles, Nashville, and Atlanta, In Los Angeles and Atlanta, the black/white relative risk of lung cancer incidence has increased. While the relative risk for prostate cancer has decreased, blacks still show an excess incidence. White women still show a higher incidence of breast cancer, but the risk is closer to one. ⋯ The excess of black prostate cancer mortality increased in Atlanta and Nashville but decreased in Los Angeles. The excess of black cervical cancer mortality fell in Los Angeles and Atlanta but rose in Nashville. These results indicate a continuing need to develop and implement culturally sensitive interventions targeted at the black population.