HDCN Article Review/Hyperlink

Ergul S, Parish DC, Puett D, Ergul A

Racial differences in plasma endothelin-1 concentrations in individuals with essential hypertension

Hypertens (Oct) 28:652-655 1996

Hypertension among blacks is more prevalent and is associated with more LVH, ESRD, stroke, and death. The reasons for this remain unclear. Endothelin-1 is a hypertensive peptide which may be involved in several types of hypertension. It's surprising that no one has looked at endothelin-1 levels in blacks vs. whites. This paper does, and finds a huge difference! Whereas ET-1 levels were similar in normotensive blacks and whites, in hypertensive blacks, mean plasma levels were about 11-12 nmol/L vs. 3-4 nmol/L in hyperensive whites.

Comment: The problem with this study is that there may have been a selection bias towards black hypertensives with more severe hypertension or with more end-organ damage. Surprisingly, such information was not analyzed in detail in this small study. For example, it appears that more whites than blacks were on medication, and the paper does not even give the mean BP levels in the patient sample broken down by blacks vs. whites, nevermind data on GFR, LVH, duration of hypertension, etc. The only things tested for were hypertension (yes/no, apparently), race, age and sex. These weaknesses leave us with intriguing preliminary data, from which causality certainly cannot be inferred. (John T. Daugirdas, M.D., University of Illinois at Chicago)

The text of the original abstract is available from the AHA at:
this site .