Figure 1

Flow diagram. Data were retrieved from PUBMED, EMBASE, LILACS, theAfrican Index Medicus, and the Food and Drug Administration and EuropeanMedicines Agency databases. *Studies were excluded using a hierarchicalapproach. First, we excluded reports that did not fulfill the maininclusion criteria (n = 2,644): an original reportconsidering drug therapy with different available drug types innon-pregnant adults of African ancestry with uncomplicated hypertension,defined as the absence of clinical heart failure, stroke or end stagerenal disease as reported by the authors. Studies conducted exclusivelyin diabetics were also excluded in this step. Of the remaining studiesfulfilling these main inclusion criteria (n = 1,119), moststudies were excluded in the next step (n = 982), becausethese were not original reports providing an explanation for thedifference in response to antihypertensive drugs between ancestrygroups. As a quality and consistency check, each paper retrieved fromthe search yield (n = 3,763) was categorized, per database,thus the excluded paper categories harbor duplicate reports, occurringin more than one database. ^† Eligible reports thusfulfilled the inclusion criteria, and were original reports consideringpotential causes for the differential response of patients of Africanancestry to antihypertensive drugs used as single drug or singledrug-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.