A drug called BiDil is poised to become the first pharmaceutical ever approved by the U.S. Food and Drug Administration (FDA) to treat heart failure specifically in African Americans—and only African Americans. On March 8, 2001, NitroMed, then a privately held biotech firm in Massachusetts, issued a press release triumphantly announcing the receipt of a letter from the FDA “describing the regulatory status and ultimate approvability of BiDil®,” pending the successful completion of a confirmatory trial of the drug in African Americans with heart failure. Press reports have already touted this breakthrough as the first “ethnic” drug to treat heart failure.

National health records have shown that African-Americans are more prone to high blood pressure than Caucasians, but pinning down the roots of that difference has proven elusive. Now, researchers at the Stanford University School of Medicine have narrowed down the search for genes that contribute to this difference in disease risk.

Finding such a gene could have several benefits for African-Americans and other ethnic groups. One is that by knowing the normal role of the gene, doctors can better understand the disease and devise new drugs or treatments to keep blood pressure under control. It could also lead to genetic tests to help identify people at higher risk of heart disease.

The work takes advantage of genetic differences between people of African and European descent to home in on the location of the gene or genes.

Hypertension results from a series of inter-related physiologic, genetic, and environmental factors. It is also more common in black patients than white patents, with a startling incidence of 39.1% among black women between the ages of 35 and 54 years. The racial differences in hypertension are evidenced both in its higher prevalence and different responses to drug therapy in black patients. In this issue of the American Heart Journal, Pescatello et al examine the relationship between race, exercise, and hypertension by measuring blood pressure response to a single exercise session in black and white women with and without hypertension… They found that although a single episode of exercise reduced blood pressure in white women with hypertension, it had quite the opposite effect in black women. Surprisingly, both black women with hypertension and black women without hypertension had a significant (P < .0001) rise in their systolic blood pressure (SBP) that was sustained for the 24 hours after the exercise session. Specifically, although the SBP decreased by 11 mm Hg in white women with hypertension, the SBP increased by 12 mm Hg in black women with hypertension after the exercise session. Black women without hypertension also had a significant rise in SBP (by 6 mm Hg) during the exercise session, with no change seen after exercise in white women without hypertension. The genetic predisposition to hypertension among blacks has been hypothesized to be related to inherited differences in salt sensitivity and low plasmarenin activity. In addition, endothelial dysfunction and variability in endothelin-1 have also been found to be impaired in black patients compared with white patients with hypertension.

In the medical journal Gut 2002;50:713-717, I. G. McFarlane of the Institute of Liver Studies, King's College Hospital, and colleagues address the “Characteristics of autoimmune hepatitis in patients who are not of European Caucasoid ethnic origin”. Abstract:

Significant diversity in disease severity has been identified for autoimmune disorders among different ethnic groups but there is a lack of data on autoimmune hepatitis (AIH) in populations other than those of European Caucasoid (EC) or Japanese extraction.

In Menopause Management 14 (2): 22-26 (April 2005), a Yale School of Nursing researcher looks at menopause differences between black and white women. "A study of African-American women in menopause shows that while they experience many of the same symptoms as white women, they report more vasomotor symptoms such as dizziness and bloating."

All of the 32 finalists in the last four Olympic men's 100-meter races are of West African descent. The probability of such an outcome by chance is all but zero. The genetic physiological and biomechanical characteristics that cause blacks to excel in some sports -- basketball, football and track -- spell disaster for those who have aspirations to be Olympic-class swimmers. Entine says, "No African American has ever qualified for the U.S. Olympic swim or dive team. Indeed, despite a number of special programs and considerable funding that have attracted thousands of aspiring black Olympians, there were only seven blacks who could even qualify to compete against the 455 swimmers at the 1996 Olympic trials." Do you suppose Professor Hopkins would charge Entine with racism?