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We sought to evaluate antihypertensive drug effectiveness and prescribing patterns among self\u2010identified Hispanic\/Latino (Hispanic), Non\u2010Hispanic Black (Black), and Non\u2010Hispanic White (White)\u00a0populations that enrolled in the NIH <jats:italic>All of Us<\/jats:italic> Research Program, a US longitudinal cohort. We employed a self\u2010controlled case study method using electronic health record and survey data from 17,718 White, Hispanic, and Black participants who were diagnosed with essential hypertension and prescribed at least one of 19 commonly used antihypertensive medications. Effectiveness was determined by calculating the reduction in systolic blood pressure measurements after 28 or more days of drug exposure. Starting systolic blood pressure and effectiveness for each medication were compared for self\u2010reported Black, Hispanic, and White participants using adjusted linear regressions. Black and Hispanic participants were started on antihypertensive medications at significantly higher SBP than White participants in 13 and 7 out of 19 medications, respectively. More Black participants were prescribed multiple antihypertensive medications (58.46%) than White (52.35%) or Hispanic (49.9%) participants. First\u2010line HTN medications differed by race and ethnicity. Following the 2017 American College of Cardiology and the American Heart Association High Blood Pressure Guideline release, around 64% of Black participants were prescribed a recommended first\u2010line antihypertensive drug compared with 76% of White and 82% of Hispanic participants. Effect sizes suggested that most antihypertensive drugs were less effective in Hispanic and Black, compared with White, participants, and statistical significance was reached in 6 out of 19 drugs. These results indicate that Black and Hispanic populations may benefit from earlier intervention and screening and highlight the potential benefits of personalizing first\u2010line medications.<\/jats:p>","DOI":"10.1002\/cpt.3360","type":"journal-article","created":{"date-parts":[[2024,7,25]],"date-time":"2024-07-25T10:56:06Z","timestamp":1721904966000},"page":"1544-1553","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Racial and Ethnic Disparities in Antihypertensive Medication Prescribing Patterns and Effectiveness"],"prefix":"10.1002","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5177-9286","authenticated-orcid":false,"given":"Slavina B.","family":"Goleva","sequence":"first","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5343-8274","authenticated-orcid":false,"given":"Ariel","family":"Williams","sequence":"additional","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Schlueter","sequence":"additional","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"},{"name":"Department of Health and Society University of Toronto Scarborough  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5316-5170","authenticated-orcid":false,"given":"Jacob M.","family":"Keaton","sequence":"additional","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5343-8822","authenticated-orcid":false,"given":"Tam C.","family":"Tran","sequence":"additional","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5086-3419","authenticated-orcid":false,"given":"Bennett J.","family":"Waxse","sequence":"additional","affiliation":[{"name":"National Institute of Allergy and Infectious Diseases, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-413X","authenticated-orcid":false,"given":"Tracey M.","family":"Ferrara","sequence":"additional","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3522-2135","authenticated-orcid":false,"given":"Thomas","family":"Cassini","sequence":"additional","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"},{"name":"Division of Medical Genetics and Genomic Medicine, Department of Pediatrics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6029-458X","authenticated-orcid":false,"given":"Huan","family":"Mo","sequence":"additional","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"},{"name":"Cohort Analytics Core, National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3049-7332","authenticated-orcid":false,"given":"Joshua C.","family":"Denny","sequence":"additional","affiliation":[{"name":"National Human Genome Research Institute, National Institutes of Health  Bethesda Maryland USA"},{"name":"<i>All of Us<\/i> Research Program National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,25]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijchy.2020.100044"},{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:122516"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.08.019"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.6.825"},{"key":"e_1_2_10_5_1","first-page":"17","article-title":"Racial differences in adherence to cardiac medications","volume":"95","author":"Charles H.","year":"2003","journal-title":"J. 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