Figure 1.

Flow diagram. Data were retrieved from PUBMED, EMBASE, LILACS, the African Index Medicus, and the Food and Drug Administration and European Medicines Agency databases. *Studies were excluded using a hierarchical approach. First, we excluded reports that did not fulfill the main inclusion criteria (n = 2,644): an original report considering drug therapy with different available drug types in non-pregnant adults of African ancestry with uncomplicated hypertension, defined as the absence of clinical heart failure, stroke or end stage renal disease as reported by the authors. Studies conducted exclusively in diabetics were also excluded in this step. Of the remaining studies fulfilling these main inclusion criteria (n = 1,119), most studies were excluded in the next step (n = 982), because these were not original reports providing an explanation for the difference in response to antihypertensive drugs between ancestry groups. As a quality and consistency check, each paper retrieved from the search yield (n = 3,763) was categorized, per database, thus the excluded paper categories harbor duplicate reports, occurring in more than one database. Eligible reports thus fulfilled the inclusion criteria, and were original reports considering potential causes for the differential response of patients of African ancestry to antihypertensive drugs used as single drug or single drug-based treatment. Included studies from the electronic searches (n = 55) [14-68], and hand search (n = 17) [12,69-84] are described in detail in the Results section.

Brewster and Seedat BMC Medicine 2013 11:141   doi:10.1186/1741-7015-11-141
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