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Diuretics Best for Hypertension and Metabolic Syndrome
Date:1/28/2008

Drugs as good or better than others in treating both conditions

MONDAY, Jan. 28 (HealthDay News) -- Diuretics appear to be as good or better than other blood pressure drugs for treating hypertension in patients with metabolic syndrome, especially black patients, according to a U.S. study.

People with hypertension and metabolic syndrome are at high risk for complications of cardiovascular disease.

Researchers at Case Western Reserve University and University Hospitals Cases Medical Center in Cleveland analyzed data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

It included 42,418 people with hypertension and at least one other risk factor for cardiovascular disease who were randomly assigned to take either the diuretic chlorthalidone (15,255), the calcium channel blocker amlodipine besylate (9,048), the alpha-blocker doxazosin mesylate (9,061), or the ACE inhibitor lisinopril (9,054).

Each drug was used to start treatment, and other drugs were added if necessary to control blood pressure. The majority of patients were followed for an average of 4.9 years, but the alpha-blocker part of the trial was halted after an average of 3.2 years due to increased rates of cardiovascular disease.

Among the patients in the study, 23,077 met the criteria for metabolic syndrome, which is defined as hypertension plus at least two of the following factors: diabetes or pre-diabetes; a body-mass index (BMI) of at least 30; high triglyceride levels; or low levels of high-density lipoprotein ("good" cholesterol).

"No differences were noted among the four treatment groups, regardless of race or metabolic syndrome status for the primary end point (nonfatal myocardial infarction [heart attack] and fatal coronary heart disease)," the study authors wrote.

Among patients with metabolic syndrome, those taking the diuretic had a lower rate of heart failure
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