Showing papers by "Jackson T. Wright published in 2007"
TL;DR: Metoprolol tartrate was associated with increased weight gain compared to carvedilol; weight gain was most pronounced in subjects with hypertension and diabetes who were not taking insulin therapy.
89 citations
TL;DR: It is concluded that in all patients high levels of blood pressure control can be achieved with commonly available medications and that Hispanic ethnicity is not associated with inferior control in the setting of a clinical trial in which hypertensive patients had equal access to medical care, and medication was provided at no cost.
Abstract: Historically, blood pressure control in Hispanics has been considerably less than that of non-Hispanic whites and blacks We compared determinants of blood pressure control among Hispanic white, Hispanic black, non-Hispanic white, and non-Hispanic black participants (N=32 642) during follow-up in a randomized, practice-based, active-controlled trial Hispanic blacks and whites represented 3% and 16% of the cohort, respectively; 33% were non-Hispanic black and 48% were non-Hispanic white Hispanics were less likely to be controlled (<140/90 mm Hg) at enrollment, but within 6 to 12 months of follow-up, Hispanics had a greater proportion <140/90 mm Hg compared with non-Hispanics At 4 years of follow-up, blood pressure was controlled in 72% of Hispanic whites, 69% of Hispanic blacks, 67% of non-Hispanic whites, and 59% of non-Hispanic blacks Compared with non-Hispanic whites, Hispanic whites had a 20% greater odds of achieving BP control by 2 years of follow-up (odds ratio: 120; 95% CI: 110 to 131) after controlling for demographic variables and comorbidities, Hispanic blacks had a similar odds of achieving BP control (odds ratio: 104; 95% CI: 086 to 125), and non-Hispanic blacks had a 27% lower odds (odds ratio: 073; 95% CI: 069 to 078) We conclude that in all patients high levels of blood pressure control can be achieved with commonly available medications and that Hispanic ethnicity is not associated with inferior control in the setting of a clinical trial in which hypertensive patients had equal access to medical care, and medication was provided at no cost
58 citations
University of California, San Diego1, Veterans Health Administration2, United States Department of Veterans Affairs3, University of Chicago4, Duke University5, Case Western Reserve University6, University of South Carolina7, Ohio State University8, University of Miami9, Johns Hopkins University10, Icahn School of Medicine at Mount Sinai11
TL;DR: African-Americans with a homozygous genotype at G12269A or homozygOUS ACE haplotypes responded to ramipril significantly faster than those with a heterozygousgenotype or heterozygOUS haplotypes, suggesting that heterosis may be an important determinant of responsiveness to an ACE inhibitor.
Abstract: ObjectiveIt has yet to be determined whether genotyping at the angiotensin-converting enzyme (ACE) locus is predictive of blood pressure response to an ACE inhibitor.MethodsParticipants from the African American Study of Kidney Disease and Hypertension trial randomized to the ACE inhibitor ramipril
45 citations
Tulane University1, Rush University Medical Center2, University of Alabama3, Washington University in St. Louis4, University of Texas at Dallas5, Mount Sinai St. Luke's and Mount Sinai Roosevelt6, University of Massachusetts Medical School7, St. John's Hospital8, Case Western Reserve University9, GlaxoSmithKline10
TL;DR: The objective is to determine whether the beneficial effects of carvedilol on insulin resistance (IR) are affected by the concomitant use of insulin sensitizers [thiazolidinediones (TZDs) and metformin].
Abstract: Aims To determine whether the beneficial effects of carvedilol on insulin resistance (IR) are affected by the concomitant use of insulin sensitizers [thiazolidinediones (TZDs) and metformin].
Methods Changes in HbA1c and homeostasis model assessment-insulin resistance (HOMA-IR) were assessed over 5 months, comparing carvedilol with metoprolol tartrate according to insulin sensitizer (TZDs and metformin) use.
Results In TZD/metformin users, carvedilol patients showed a 5.4% decrease [95% confidence interval (CI) −11.9, 1.6; P = 0.13] and metoprolol tartrate patients showed a 2.8% decrease (95% CI −8.5, 3.2; P = 0.35) in HOMA-IR. The −2.6% difference between treatments was not significant (95% CI −10.7, 6.2; P = 0.55). In contrast, those not taking TZD/metformin experienced a 13.2% increase in HOMA-IR on metoprolol tartrate (95% CI 3.2, 24.1; P < 0.01) and a 4.8% decrease in HOMA-IR on carvedilol (95% CI −14.6, 6.0; P = 0.37), with a significant treatment difference of −15.9% favouring carvedilol (95% CI −26.6, −3.6; P = 0.01). There was no significant treatment interaction for the use of TZD/metformin and HbA1c. A statistically significant treatment difference was observed for HbA1c after 5 months favouring carvedilol after adjusting for insulin sensitizer use (−0.11%, 95% CI −0.214, −0.009; P = 0.03).
Conclusions In patients with diabetes and hypertension not taking insulin sensitizers, the use of metoprolol tartrate resulted in a worsening of insulin resistance, an effect not seen with carvedilol. However, in TZD/metformin users the difference between the β-blockers was not statistically significant.
28 citations
TL;DR: The effects of β‐blockade in addition to more specific renin‐angiotensin system (RAS) blockers on blood pressure (BP) in patients with diabetes are described and carvedilol compared with metoprolol did not effect glycemic control.
Abstract: The effects of β-blockade in addition to more specific renin-angiotensin system (RAS) blockers on blood pressure (BP) in patients with diabetes are described. After washout of medications other than angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, patients were titrated to a BP level <130/80 mm Hg using therapy with carvedilol 6.25 to 25 mg bid (n=498) or metoprolol tartrate 50 to 200 mg bid (n=737). At the end of the β-blocker titration period, a BP level <130/80 mm Hg was achieved in 37% of carvedilol-treated and 36% of metoprolol-treated participants who continued to receive a renin-angiotensin system blocker. In the approximately 60% of participants in whom a BP level <130/80 mm Hg was not attained with renin-angiotensin system blockade plus β-blockade, hydrochlorothiazide was added in 43% and 44% of carvedilol and metoprolol groups, respectively; 25% (both arms) also required a calcium channel blocker. Among those in whom goal BP was not achieved, 42% of carvedilol- and 40% of metoprolol-treated participants were not titrated to the highest dose of β-blocker. The use of carvedilol compared with metoprolol did not effect glycemic control.
18 citations
TL;DR: This case discussion was presented originally in an open forum on May 5, 2006, in Baltimore, MD, sponsored by the Department of Veterans Affairs Maryland Health Care System and the University of Maryland School of Medicine as part of an ongoing series of historical clinicopathological conferences.
Abstract: This case discussion was presented originally in an open forum on May 5, 2006, in Baltimore, MD, sponsored by the Department of Veterans Affairs Maryland Health Care System and the University of Maryland School of Medicine as part of an ongoing series of historical clinicopathological conferences.
2 citations
TL;DR: A panel was convened to discuss the topic of the management of hypertension in the African American patient and each author received an honorarium from Novartis for time and effort spent participating in the discussion and reviewing the transcript for important intellectual content prior to publication.
Abstract: A panel was convened to discuss the topic of the management of hypertension in the African American patient. Jackson T. Wright, MD, PhD, Professor of Medicine, Case Western Reserve University, Cleveland, OH, moderated the panel. Kenneth A. Jamerson, MD, Professor of Medicine, University of Michigan, Ann Arbor, MI, and Keith C. Ferdinand, MD, Association of Black Cardiologists, Inc, and Emory University, Atlanta, GA, participated in the discussion. This expert panel discussion was supported by Novartis and each author received an honorarium from Novartis for time and effort spent participating in the discussion and reviewing the transcript for important intellectual content prior to publication. The authors maintained full control of the discussion and the resulting content of this article; Novartis had no input in the choice of topic, speakers, or content.
2 citations
1 citations