Adverse drug reactions (ADRs) are an important cause of ill health and death. Several factors including genetic make up, age, sex, and even diet, can all alter a patient's susceptibility to ADRs. But it is not known to what extent susceptibility to ADRs might depend on ethnic group, whether as a result of genetic or cultural factors.

Researchers searched the scientific literature and identified 24 studies that included data for adverse reactions to cardiovascular drugs for at least two ethnic groups. Differences in study quality were assessed to identify and minimise bias.

They found that the risk of angio-oedema (swelling) with blood pressure lowering drugs was three times greater in black patients than non-black patients. The risk of cough was also nearly three times higher in East Asian patients compared with white patients.

For clot-busting therapy, the risk of bleeding increased 1.5-fold in black compared with non-black patients.

Some ethnic groups may be more susceptible to adverse reactions during treatment with cardiovascular drugs, say the authors. These findings may help doctors present more accurate and relevant data to their patients when prescribing cardiovascular therapy. However, differences in study quality and inconsistent reporting of harms mean that these results need to be interpreted cautiously, they add.

Future studies must report both adverse reactions and racial and ethnic classifications more fully, if we are to discover how they are linked, they conclude.

bmj

Professor Wardle advises parents whose teenage child is significantly overweight to handle the issue in a sensitive way, avoiding criticism and focusing on concerns over future weight gain rather than their existing weight.

She also said making healthy eating easier at home could help adolescents and a good diet which includes plenty of fresh fruit and vegetables and high fibre foods like wholemeal bread would benefit teens.

It is also important to encourage children to take regular exercise. Playing sports or running in the park are healthier occupations than playing computer games, says Wardle.

The findings were less clear cut for economic status. 35% of the most deprived girls were overweight or obese compared with 28% of other girls, but other economic categories showed less consistency.

The authors say that it is clear that children who are obese when they enter secondary school will very likely leave it obese, and more monitoring is crucial if rising tides of obesity are to be tackled effectively.