Contributed by William Angelos| 05 April, 2005 22:58 GMT
Diuretics are similar to or superior to newer drugs in lowering blood pressure, in tolerability and in preventing the major complications from high blood pressure.
Older, cheaper diuretics remain the drug of choice for treating high blood pressure and reducing risk of heart disease in patients of all racial backgrounds, says an article published in the April 6 issue of the Journal of the American Medical Association.
The three co-authors of the article, all faculty members at the University of Texas School of Public Health at Houston, conducted a study by race, called the "Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial" (ALLHAT). Their findings confirm earlier research indicating that diuretics, rather than newer, more expensive drugs -- such as ACE inhibitors, calcium channel blockers, or beta blockers -- should be preferred as a first therapy for most patients.
As Good or Better Than Newer Drugs
The multi-center ALLHAT study was conducted under a National Institutes of Health contract with The University of Texas Health Science Center at Houston. Principal Investigator Barry R. Davis, M.D., Ph.D., professor of biostatistics in the UT School of Public Health,co-authored the JAMA article.
"There was [a] question whether the diuretics' success with hypertension applied by race because black patients have less success than non-black patients with the ACE inhibitors," said Davis, who also is director of the Coordinating Center for Clinical Trials at the UT School of Public Health. "However, the results showed diuretics were as good or better than the newer drugs, regardless of race."
The study concludes that diuretics are similar to or superior to newer drugs in lowering blood pressure, in tolerability and in preventing the major complications from high blood pressure.
Diuretics Are Safer for the Heart
Across both racial subgroups, there was substantially higher risk of heart failure -- 37 percent -- among participants taking calcium channel blockers compared with those on diuretics.
When compared to ACE inhibitors, diuretics were more effective in preventing cardiovascular disease, especially heart failure, for all participants -- and significantly more effective in reducing high blood pressure and preventing stroke in blacks.
"These findings confirm ALLHAT's original conclusion that diuretics should be the preferred initial therapy for high blood pressure," Davis said. |
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