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Ethnicity and cardiovascular disease

Therese Tillin is a clinical epidemiologist currently working on a portfolio of studies exploring the risks of vascular and metabolic diseases among ethnic groups. One of these studies is the SABRE study, a 5-year programme grant funded jointly by the Wellcome Trust and British Heart Foundation, which is following more than 4,000 people of European, South Asian and African Caribbean descent for a 20-year period. Over 2,000 survivors from this study will undergo detailed non-invasive clinical investigations.

Her other research work includes the use of intravascular ultrasound to characterise atherosclerotic plaque and the response of the coronary arteries to the presence of plaque in people of South Asian and European descent. She is also planning a programme of work to determine the effects of different sites of fat distribution on insulin resistance and heart disease in both young and older people.

‘The SABRE study aims to identify explanations for the striking differences in diabetes and cardiovascular disease between ethnic groups.’

Therese Tillin

 

 

 

 

 

 

 

 

 

Therese Tillin

 

 

Optimising hypertension treatment in different ethnic groups

Most guidelines for managing hypertension do not consider the ethnicity of the patient in the selection of initial or subsequent treatment. To address this, Dr Ajay Gupta investigated differences in the blood pressure response between 5,425 white, black and South Asian patients with hypertension included in ASCOT. Patients received a beta-blocker or calcium channel blocker as monotherapy and a diuretic or angiotensin-converting enzyme inhibitor as second-line therapy.

This study has provided the first evidence of ethnic differences in the blood pressure response to second-line agents. These findings question current recommendations from the British Hypertension Society and NICE on the choice of second-line agents for black hypertensive patients. To address this question, a trial is planned to compare the blood pressure lowering efficacy of a two-drug combination recommended by these guidelines with the proposed combination of calcium channel blocker and diuretic, individually shown to be effective in black hypertensive patients.

‘If this combination is shown to be more effective in lowering blood pressure, this would potentially lead to a change in national guidance for black patients with hypertension. This would have the potential to improve blood pressure control and reduce adverse cardiovascular outcomes among the high-risk patients belonging to this ethnic group.’

Dr Ajay Gupta

Ajay Gupta
Contact: Eric Stevenson   59-61 North Wharf Road   London   W2 1LA   info@ffch.org