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Consider Weight When Choosing Blood Pressure Meds: Study
Date:12/6/2012

By Steven Reinberg
HealthDay Reporter

THURSDAY, Dec. 6 (HealthDay News) -- Taking a patient's weight into account when choosing blood pressure medications might help prevent strokes, heart attacks and death, a new study suggests.

Lean and obese people react differently to different blood pressure medications, said the researchers, who believe their findings could change the way high blood pressure (hypertension) is treated.

"Unexpectedly, people who have high blood pressure and are fat actually have a better prognosis than people who have high blood pressure and are thin," said lead researcher Dr. Michael Weber, a professor of medicine at Downstate Medical Center of the State University of New York in New York City.

"You can now choose blood pressure medication as a means of compensating for this difference between obese and thin people, so that it's possible to treat everybody with a medicine that maximizes the outcome regardless of how much you weigh," he said.

Weber recommends starting all patients with high blood pressure on a class of drugs called calcium channel blockers, regardless of weight. One such drug is Norvasc (amlodipine).

Although diuretics, which reduce excess water in the body, are effective in obese patients, they can harm thin patients, and should be relegated to a third-line therapy, Weber said.

Obese people respond better to diuretics, Weber explained, because their hypertension is often caused by a combination of excess weight, too much fluid and too much salt. Thin hypertensive patients, he said, may have underlying circulatory problems that are causing their high blood pressure and placing them at increased risk for cardiovascular disease.

For the study, published in the Dec. 6 online edition of The Lancet, Weber's group analyzed data on more than 11,000 individuals in an international high blood pressure trial.

That trial compared treatment with
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