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Adding Drug Doesn't Help Control Blood Pressure
Date:10/23/2009

for people whose cardiac problems did not include heart failure, and the risk of heart attack by about 17 percent. Adding an ARB drug did not reduce the risk further, but did increase the rate at which drug therapy was discontinued because of side effects such as fainting.

"We showed results similar to what they [the authors of the new study] did," said Dr. Sripal Bangalore, a fellow in interventional cardiology at Brigham and Women's Hospital in Boston, who published a similar meta-analysis a year ago. "Our study showed that the addition of an ARB to an ACE inhibitor did not give any benefit in terms of heart endpoint, unless in patients who had heart failure."

The lesson for doctors prescribing drugs for blood pressure control in people with stable heart disease is clear, Bangalore said: "Based on current studies, combination therapy should be avoided."

Current guidelines by organizations such as the American Heart Association already reflect that lesson. Guidelines generally recommend ACE inhibitors as a first-line therapy for high blood pressure.

More information

For more on high blood pressure and how to control it, visit the U. S. National Heart, Lung, and Blood Institute.



SOURCES: Jean Slutsky, MSPH, director, U.S. Agency for Healthcare Research and Quality Center for Outcomes and Evidence, Bethesda Md.; Sripal Bangalore, M.D., interventional cardiologist, Brigham and Women's Hospital, Boston; Oct. 20, 2009, Annals of Internal Medicine


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