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New Medication Reduces Heart Failure in African Americans

A new drug that significantly reduces the number of deaths from heart failure among African-Americans has undergone successful testing in the United States. Scientists say African-Americans are more than twice as likely to suffer from heart failure than whites.

Researchers unveiled the new drug BiDil at the November 8 meeting of the American Heart Association in New Orleans, Louisiana. They tested the drug on more than 1000 people in the largest all-black medical trial ever conducted. African-Americans who took BiDil with their regular treatment during the three-year study had a 43 percent higher chance of surviving heart failure than those who took a placebo along with their standard heart failure medication.

BiDil employs a combination of two well-known generic medications in a single pill to boost nitric oxide in the blood. Heart specialist Dr. Anne Taylor, a director of the project and Associate Dean of the University of Minnesota medical school, says that African-Americans with low levels of nitric oxide are likely to suffer from high blood pressure that can be an early sign of heart disease.

"If you have a relative deficiency of nitric oxide combined with an extra stressor to the heart such as high blood pressure, this may be one of the factors that drives the prevalence and the development of heart failure in African-Americans especially," says Dr. Taylor.

Tests 25 years ago found that African-Americans demonstrated a better response than whites to BiDil's two component ingredients, isosorbide dinitrate and hydralazine. Dr. Taylor says those early results led researchers to focus their current study exclusively on black patients because the beneficial effect of the substances was seen primarily and most strongly on the African-American racial group.

"This was not just an arbitrary decision to test something in an African-American population," she notes. " There was a trail of evidence that suggested that this particular combination would have particular efficacy in an African-American population."

While BiDil has started to draw a share of critics who challenge its race-specific use, some detractors say that identifying the medication as a drug for blacks could delude patients into basing their decision of whether to take it solely on race or ethnicity. Dr. Taylor says there's a good chance the controversy over racial targeting is likely to fade away over time.

"There are populations of individuals who have different health vulnerabilities as well as different responses to medication," adds Dr. Taylor. "By exploring those differences, we understand disease mechanisms better, but we can also target therapy. Now having said that, we don't think that African-Americans are the only people who will benefit from this medication. It may well have applications in Africa, in Europe, in Asia. So just limiting it to just one ethnic group was a beginning of understanding this particular mechanism of action, but it is not the end of the story."

Details of the University of Minnesota heart drug study are being published in the November 11th edition of the New England Journal of Medicine.