Update on the VA cooperative study group on antihypertensive agents data regarding race and age.

The VA Cooperative Study Group on Antihypertensive Agents published its main findings in the NEJM 1993; 328:914-921. Subsequently, we discovered an error in the computer code that caused an underestimation of the percent success rates at one year. The corrected data were published in NEJM 1994;330:1689 and the corrected figures in Am J Hypertens 1995 (Feb) along with the data recalculated using a criterion of < 90 mm Hg. A second part of the study looked at those 410 patients who failed treatment with the initial single drug. Of 352 who qualified for randomization to the alternate drug, 173 (49.1%) achieved goal DBP and 102 (29%) failed the alternate drug. Response rates ranged from 37-63% across the 6 drugs. Response rate in blacks was 46.4% and 54.0% in whites. Younger blacks and whites responded less well than older patients. We concluded that sequential monotherapy was a viable alternative to stepped care. These data will be published in the Arch Intern Med in the fall of 1995. In a subset of 692 men for whom echocardiographic data were available, the prevalence of LVH by ECG was greater for blacks (31%) than whites (10%), but there was no racial difference in LVH or LV mass by echo. Septal, posterior LV and relative wall thickness were greater in black men (JACC 1994;24:1492-98).