J Natl Med Assoc
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Since the cloning of the cystic fibrosis (CF) gene and the identification of delta F508, the most common CF mutation, screening the general population for CF has been vigorously debated. Adding to the controversy is the question of whether screening should be offered to African Americans, whose incidence of CF (1/17,000) is much lower than that of whites (1/2500). We tested for five common mutations (delta F508, G551D, G542X, R553X, and N1303K) in order to determine the frequency of common mutations in African Americans with CF from the southeastern United States. delta F508 was found on 50% of CF chromosomes; 46% of CF mutations were undetermined mutations. Our data indicate that at the current detection rate, the sensitivity of CF screening in African Americans would be appreciably lower than that of whites, and thus their inclusion in screening programs probably would not be warranted.
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Hypertension is highly prevalent among African Americans, who are also more likely than whites to develop end-organ complications of hypertension. Traditional diuretic-based stepcare therapy has successfully reduced such complications of hypertension as stroke, congestive heart failure, and premature death in all populations tested. ⋯ Use of antihypertensive agents lacking adverse metabolic effects but still achieving effective blood pressure control could improve cardiac outcomes while maintaining the benefits achieved with older forms of therapy. Achievement of improved cardiac outcomes is now one of the principal goals of hypertension research and treatment.