Navigation Links
All Blood Pressure Drugs Lower Risk of Heart Attack and Stroke
Date:5/7/2009

Any are better than no treatment at all, study shows

THURSDAY, May 7 (HealthDay News) --Lowering blood pressure is essential for reducing the risk of heart disease and stroke, but which drugs are best has been a matter of debate.

Now, two new analyses attempt to answer that question.

Their conclusions: For heart attacks, all antihypertensive drugs work, with the exception of angiotensin receptor blockers (ARBs), probably because there aren't enough studies to confirm their benefit. For stroke, all antihypertensive drugs were better than placebo, but diuretics, ARBs or calcium channel blockers were significantly better than beta blockers or angiotensin-converting enzyme (ACE) inhibitors. Both reports were presented Wednesday at the American Society of Hypertension's annual meeting, in San Francisco.

"Physicians and patients should be reassured that, based on all the world's literature, sliced and diced in many ways, subjected to two separate and distinct types of meta-analyses, antihypertensive drugs do reduce the risk of the two most feared endpoints related to hypertension: heart disease and stroke," said lead researcher Dr. William J. Elliott, a professor of preventive medicine, internal medicine and pharmacology at Rush Medical College in Chicago.

For the first study, Elliott's team analyzed data from 57 trials that looked at treatment for high blood pressure and the reduction of heart attack risk.

The researchers found that, except for ARBs, all drugs were significantly better than placebo or no treatment in lowering blood pressure and reducing the risk of heart disease. Among all the drugs, ACE inhibitors were slightly better, however, the difference was not statistically significant.

These findings confirm other research that has shown that ARBs may not be as effective at preventing heart attack as other blood pressure drugs, and that ACE inhibitors are especially effective at preventing heart disease. That benefit may be due to other effects of the drug, not just its ability to lower blood pressure, the researchers noted.

In addition, this study may help end the debate about which diuretics are best. Elliott's group found that there was no difference among different diuretics in preventing heart attack or sudden cardiac death.

"We presume the lack of significance with ARBs stems from the fact that this is the newest class of drugs, and therefore fewer trials involving fewer patients having fewer coronary heart disease events [half to a third of other classes] limits the statistical power of the analysis," Elliott said.

In the second report, Elliott's team analyzed 60 clinical trials involving 279,371 patients. In their analysis, the researchers also found that blood pressure-lowering drugs were significantly better than placebo or no treatment in reducing the risk of stroke.

Starting treatment with a diuretic reduced the risk of stroke by 55 percent, while beta blockers reduced the risk by about 22 percent, and ACE-inhibitors reduced the risk by about 16 percent. Starting treatment with a diuretic, ARB or calcium channel blocker did not produce significantly different results, the researchers added.

As with the other analyses, there was no significant difference between diuretics in preventing stroke.

"All antihypertensive drug classes are significantly better than placebo/no treatment to reduce the risk of stroke," Elliott said.

Although there are some differences in stroke prevention between the different antihypertensives, the data suggest that diuretics and calcium channel blockers may be more effective in preventing stroke than heart attack.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, does not think these studies answer the question of which blood pressure medication is best. The bottom line is that lowering blood pressure by any means is important in reducing the risk for heart attack and stroke.

"Patients with hypertension are at increased risk for heart attacks and strokes, and reducing blood pressure to goal levels is essential to lower this risk," Fonarow said. "Clinicians and researchers continue to debate whether there are important differences among the specific medications in reducing risk."

These two studies involved pooling together different randomized trials to explore the relative differences for coronary heart disease and stroke risk with different classes of antihypertensive agents, Fonarow said.

"Despite the large number of studies and patients, due to differences in the on-treatment blood pressures achieved in the various studies, something which was not controlled for in these analyses, no firm conclusions can be drawn," Fonarow said. "Furthermore, recent large scale randomized clinical trials where similar blood pressures have been achieved provide entirely different conclusions."

"Achieving and maintaining control of blood pressure to goal levels with lifestyle changes and, when indicated, anti-hypertensive medications is far more important than which specific anti-hypertensive medication is selected," he said.

More information

For more on heart disease and stroke, visit the American Heart Association.



SOURCES: William J. Elliott, M.D., Ph.D., professor, preventive medicine, internal medicine and pharmacology, Rush Medical College, Chicago; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; May 6, 2009, presentations, American Society of Hypertension annual meeting, San Francisco


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Specific antagonism lowers blood pressure
2. Restricting Blood Flow May Help Heart Bypass Patients
3. FDA Updates Prescription Guidelines for Blood Thinner
4. Doctors Often Miss High Blood Pressure in Kids
5. Back to School Means Return of School Blood Drives
6. Blood-flow detector software show promise in preventing brain damage
7. FDA Approves New Roche West Nile Virus Blood Screening Test
8. Australian-led international study shows blood pressure drugs cut death rate in type 2 diabetes
9. Laser blasts viruses in blood
10. Study Demonstrates Marteks Algal DHA Oil Improves Blood Triglyceride Lipid Levels
11. LifeMasters Provides Tips for Maintaining a Healthy Blood Cholesterol Level
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
All Blood Pressure Drugs Lower Risk of Heart Attack and Stroke
(Date:10/13/2017)... WI (PRWEB) , ... October 13, 2017 , ... As ... in medicine known as “patient engagement.” The patient is doing more than filling out ... partners. , “There is an increasing emphasis in health care and research on ...
(Date:10/13/2017)... ... October 13, 2017 , ... The International Association of ... of excellence for the field of eating disorders, announces the opening of early ... in Orlando, Florida at the Omni Resort at ChampionsGate. , The ...
(Date:10/13/2017)... ... 13, 2017 , ... Lori R. Somekh, founder of the Law Office ... of elder law and special needs planning attorneys. “Membership in ElderCounsel helps our office ... forum to network with elder law attorneys nationwide,” said Somekh. , ElderCounsel ...
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... The Visiting ... Day Market. Featuring a collection of specialty vendors and unique items from across the ... and quality-focused health and wellness services offered by the VNA. The boutique will ...
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... Yisrayl Hawkins, ... week that explains one of the most popular and least understood books in the ... cryptic and puzzling descriptions that have baffled scholars for centuries. Many have tossed it ...
Breaking Medicine News(10 mins):
(Date:10/12/2017)... --  Divoti USA will engrave and process all ... the latest FDA requirements, which stipulates new criteria regarding medical device ... of Medical ID jewelry such as Medical ID Bracelets, can rest ... terms of the new FDA requirements . ... Divoti offers this dark mark fiber laser engraving ...
(Date:10/11/2017)... , Oct. 11, 2017  Caris Life Sciences ... on fulfilling the promise of precision medicine, today announced ... joined Caris, Precision Oncology Alliance™ (POA) as its 17 ... centers, the St. Jude Crosson Cancer Institute will help ... the use of tumor profiling, making cancer treatment more ...
(Date:10/10/2017)... ORANGE COUNTY, Calif. , Oct. 10, 2017  NDS received ... Mobile  — a medical-grade battery-powered display stand specifically designed for ... aims to transform technology into a clinical solution to support the ... costs. Innovative Design ... NDS ZeroWire Mobile Wireless Solution ...
Breaking Medicine Technology: