Best wishes,

Paul

I can understand how some medications can be designed for persons who have a very specific genetic background. However, black Americans are not an isolated racial group. To the contrary, black Americans are probably one of the most genetically diverse groups of people who have ever existed.

Black Americans beyond having an eclectic genetic connection to the multiple peoples who inhabit West Africa, many black Americans have both European and Native American ancestry. And let us not fail to mention about blacks immigrating from Africa and the Caribbean to the United States, who become “black Americans”, once they reach these shores. Are medications made for “black Americans” beneficial to the newest arriving black Americans?

My brother, who is a black American, suffers with idiopathic torsion dystonia, a neurological movement disorder that has its highest incidence among the European Jewry. Many of his doctor’s are baffled that a black man has this rare disease, until they probe for my brother’s known genetic history. Our maternal great grandfather was a German Jew. Many black Americans have similar mixed ethnic identities, although we are socially and self-identified as black Americans.

We must be careful that the development of race based drugs like BiDil is not directed by misguided science. I hope that scientists are not allowing mistaken perceptions of race and pharmaceutical companies their greed to cloud the scientific process, by incorrectly manufacturing and marketing drugs based on race.

Moreover, we must ensure that the black community is not used for 21st Century medical experimentation, like blacks were used in the Tuskeegee experiment.

Benin Dakar
Duluth, GA

Medpundit: more on why the case-control NEJM study purportedly supporting decreased risk of colorectal cancer by taking statins is hogwash: lack of matching of ethnic group, differences in # askenazi jews ” if the researchers really wanted to see if …

Dr. Michael Jacobson has an excellent post on a recent Israeli case-control study on statins and colorectal cancer that’s worth reading in full:

Why don’t we just put statins in the water supply and be done with it?
In last week’s NEJM is a ca…

Estrogen HRT was looking promising for a number of indications before the large RCTs were done. And then we had to call all our female patients to stop the “magic pill”.

This is the Tamhane’s law (named after one of my colleagues): a new study is out and then the doctors run in its direction as fast as they can, prescribing the new drug left and right, Then, several years later, another new study shows no benefit or even harm. Then, the doctors run just as fast in the opposite direction. (Have a mental picture of a flock of sheep).

I just think this study points out that, much as we might like to, we shouldn’t automatically assume that a generic medication in the same class as other drugs will necessarily translate to the same benefits. It might, and it probably usually will, but we need to at least consider the possibility that this will not be the case. Certainly, the shorter half-life of atenolol should be taken into account, and dosing schedules perhaps adjusted accordingly.