While the primary endpoint showed no difference between drug treatment groups, subset analysis of the metabolic syndrome showed less heart failure when diuretics are used. This subset analysis emphasizes the value of diuretic treatment in patients with the metabolic syndrome who are subject to heart failure, said Gould, the Martin Bucksbaum Distinguished University Chair.
Diuretics lower blood pressure by reducing fluid from blood. The other classes of blood pressure medication tested during the trial included: calcium channel blockers which relax blood vessels; ACE inhibitors which prevent the formation of a hormone which causes blood vessels to narrow; and alpha blockers, which reduce nerve impulses that constrict vessels.
Among patients with the metabolic syndrome (7,327 black and 15,750 white patients), the calcium channel blocker, ACE inhibitor and alpha-blocker had higher rates of heart failure compared with the diuretic; the ACE inhibitor and the alpha-blocker also had an increased risk of combined cardiovascular disease.
The latest findings stem from a landmark investigation based at the UT School of Public Health, which in 2002 established that diuretics were as good or better than three other classes of medications for high blood pressure during a multi-center, randomized, double-blind, clinical trial. The investigation is called ALLHAT - Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.
Also contributing to the study from the UT School of Public Health were Sara Pressel, M.S., a faculty associate in biostatistics and co principal investigator of ALLHAT, and Charles Baimbridge, a graduate student in biostatistics.
This study once again demonstrates that thiazide-type diuretics are an effective and inexpensive thera
|Contact: Robert Cahill|
University of Texas Health Science Center at Houston