An Old Drug Combination Tested in Black Patients

The combination of isosorbide dinitrate and hydralazine lost favor in the treatment of heart failure (HF) after the ACE inhibitor enalapril proved to be superior in the V-HeFT II trial more than a decade ago. However, subsequent research has suggested that ACE inhibitors might not be as effective in black patients as in white patients (Journal Watch Cardiology Jun 15 2001). One theory is that genetic variability may underlie drug-response variation among racial groups. There is some evidence of racial differences in the bioavailability of nitric oxide and in renin-angiotensin activity, both of which isosorbide-hydralazine combination therapy might address.

These researchers conducted a multicenter, randomized trial of placebo versus a fixed-…