variation within race, as well as, differences across racial groups. For example, a meta-analysis of 15 clinical trials found that blacks and white patients differ in their responses to antihypertensive medications with white patients responding better to beta blockers and ACE inhibitors and blacks responding better to diuretics and calcium channel blockers.143 However, the variation within each race was three to four times the size of the average racial difference with almost 90% of blacks and whites having similar responses to all antihypertensive medications. Thus, in contrast to conventional medical wisdom, a patient’s race provides little guidance to the clinician in the choice of antihypertensive medication. The bottom-line is that a genetic explanation of residual race effects conflates self-reported racial status with inferred genetic traits and neglects evidence that indicates that exposures to social factors over the life course can increase risk for disease.144
