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Blood Pressure Pill Combo More Effective Than Diuretics

Study suggests need to change therapeutic guidelines,,,,

WEDNESDAY, Dec. 3 (HealthDay News) -- A pill that contains two blood pressure drugs was more effective than a diuretic-based strategy in reducing the risk of serious cardiovascular problems and death in people with high blood pressure, according to a study that included more than 11,000 patients in the United States, Sweden, Norway, Denmark and Finland.

The patients took either a tablet containing benazepril (an ACE inhibitor) and amlodipine (a calcium channel blocker) or a tablet that contained benazepril and hydrochloro-thiazide, a type of diuretic (water pill). Both combination pills helped reduce blood pressure in more than 75 percent of patients, but those taking the first pill had 20 percent fewer cardiovascular events than those taking the other combination pill with the diuretic. The study defined cardiovascular events as cardiovascular deaths, heart attacks, strokes, hospitalization for unstable angina, and treatments to reopen blocked heart arteries.

The Avoiding Cardiovascular Events Through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) study was published in the Dec. 4 issue of the New England Journal of Medicine.

The results were so significant that the trial was stopped early, said the authors of the study, which was funded by Novartis, one of the companies that offer two-drug tablets for treatment of high blood pressure. The researchers said the findings suggest the need to change current blood pressure control guidelines, which call for initial treatment with a diuretic, with other drugs added only as needed to lower blood pressure.

"This robust study showed us that switching patients to a single-pill combination meant that twice as many patients got to their blood pressure goal, regardless of previous therapy," study leader Dr. Kenneth Jamerson, a professor of internal medicine at the University of Michigan Medical School and a member of the U-M Cardiovascular Center, said in a university news release.

"The significant reduction in cardiovascular events we observed in patients will, I hope, show physicians that earlier use of a combination medicine, especially with amlodipine, may be in the best interest of the patients," Jamerson said.

As many as 73 million Americans have high blood pressure, which increases the risk of stroke, heart attack, heart failure and other health problems. Drugs can help control blood pressure, but many patients have trouble taking the multiple medications they need, which is why combination pills were developed, according to background information in the news release about the study.

More information

The American Heart Association has more about blood pressure-lowering drugs.

-- Robert Preidt

SOURCE: University of Michigan Health System, news release, Dec. 3, 2008

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