(The Associated Press) -- New research appears to contradict a widely publicized study that concluded that cheap, old-fashioned diuretics should be the first drug given to people with high blood pressure.
February 14, 2003
By Mary Pickett, M.D.
Harvard Medical School
How does this article relate to me?
If you have hypertension, you might be confused by the fact that two different classes of blood pressure medicines have made it into the news during the past three months, each one declared to be the "best" treatment. The first study was a long-awaited eight-year trial that followed the progress of 33,000 patients in the United States. This trial observed that people who were treated with thiazide-type diuretics had the greatest reduction in strokes and cardiac events, compared to people who took a blood pressure medicine from the ACE inhibitor group or other class of medicines. The more recently published study evaluated just over 6,000 people in Australia, and the data from this group was contradictory. Especially for older men, the Australian study appeared to tip in favor of ACE inhibitors over diuretics, finding the most protection from cardiac events with ACE inhibitor treatment. So who is the real winner? If you have hypertension, YOU are. It is clear that you have many excellent options to choose from when you select a medicine to treat blood pressure. Both of these studies were rigorously designed and conducted. More than anything else, the difference in results shows that these medicines are in a close race and are nearly equally effective.
What changes do I need to make?
These recent studies should not dictate your choice of blood pressure medicine (or medicines). Rather, your doctor should assist you in weighing the potential advantages of available medicines in a way that is personalized to your health conditions, side effect experience, and financial needs. Medications from the thiazide diuretic group, the ACE inhibitor group, or the group of medicines known as beta blockers are all excellent choices as a first treatment for hypertension.
What can I expect in the future?
If you can bring your blood pressure down to an ideal level with any one of (or any combination of) the leading available treatments today, then you can enjoy the following health benefits:
- Your risk for stroke will be reduced by 30 to 50 percent.
- Your risk of coronary heart disease (angina and heart attack) will be reduced by 20 to 40 percent.
- Your risk of congestive heart failure will be reduced by 40 to 80 percent.
- Your risk of premature death will be reduced by 10 to 20 percent.
Related Areas:
High Blood Pressure
Heart Conditions
