Better Treatment for Hypertension
Reported March 9, 2005
ORLANDO, Fla. (Ivanhoe Newswire) — Conclusions from a new study call for newer, antihypertensive treatment strategies to replace conventional ones where appropriate.
Researchers have debated whether newer, antihypertensive strategies that use calcium channel blockers and ACE inhibitors are superior to older treatments with beta blockers and diuretics.
Peter S. Sever, M.D., of Imperial College in London, presented preliminary results from the study at the American College of Cardiology 54th Annual Scientific Session in Orlando, Fla.
About 20,000 hypertensive patients either received the calcium channel blocker amlodipine with or without the ACE inhibitor perindopril or the beta-blocker atenolol with or without the diuretic bendroflumethiazide. The study examined treatment strategies as opposed to response to individual drugs, because Dr. Sever says, Most people with high blood pressure require at least two drugs to achieve target pressures.
The trial ran for five years, but it was prematurely stopped after concerns arose that patients taking the beta-blocker and diuretic combination were at a continued significant disadvantage. Dr. Sever says: All-cause mortality was different in those on the beta-blocker and diuretic than those on the calcium channel blocker and ACE inhibitor. There was a highly significant risk-reduction of about 15 percent in those assigned the calcium channel blocker and ACE inhibitor.
Fatal heart disease events were reduced by 10 percent for those on the newer treatment. Dr. Sever says although this number is not significant, the trial was stopped early, and it would have likely been a higher percentage if it had continued.
Of patients on the newer treatment, all coronary events were reduced by about 15 percent. Strokes and cardiovascular mortality were reduced by about 25 percent.
Additionally, patients on the older treatment had about a 30-percent greater chance of developing type 2 diabetes.
The final study results will be published later this year, but Dr. Sever says this preliminary data represents more than 95 percent of the final data, and the numbers will not change much.
SOURCE: Heather Kohn at the American College of Cardiology 54th Annual Scientific Session in Orlando, Fla., March 6-9, 2005
