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

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 physicians' 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.