Diuretics Best Choice for Treating Hypertension

A long-term, multicenter trial that compared diuretics with calcium channel blockers and angiotensin-converting enzyme (ACE) inhibitors for lowering blood pressure has shown that diuretics are superior. The results were reported in the December 18, 2002, issue of The Journal of the American Medical Association (JAMA).

The trial also included a cholesterol-lowering study that compared the effects of a statin drug with "usual care.” The difference in cholesterol levels was too small to show a difference in death rates and demonstrated only a nonsignificant decrease in the rate of heart attacks and strokes in the statin group. An arm of the trial included study of an alpha-adrenergic blocker but was stopped because those on the drug had 25% more cardiovascular events and were twice as likely to be hospitalized for heart failure than users of diuretics.

After about five years of follow-up, patients on the calcium channel blocker had 1 mm Hg higher systolic blood pressure and a 38% higher risk of developing heart failure than those taking diuretics. Patients taking ACE inhibitors had 2 mm Hg higher systolic blood pressure, a 15% higher risk of stroke, and a 19% higher risk of developing heart failure.
The study involved more than 42,000 participants with hypertension and at least one other risk factor for heart disease.

The researchers say patients now taking one of the newer medications for hypertension should talk to their doctor. "The new findings will allow doctors to achieve better blood pressure control and, more importantly, better cardiovascular health for their patients. And, they will do this at a more affordable price for their patient,” said Dr. Jeffrey Cutler, senior advisor at the US National Heart, Lung, and Blood Institute (NHLBI) which conducted the trial.




Related Links:
US National Heart, Lung, and Blood Inst.