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Risks May Outweigh Benefits for Blood Pressure Drug Combo
Date:3/22/2011

By Alan Mozes
HealthDay Reporter

TUESDAY, March 22 (HealthDay News) -- Many older people struggling with high blood pressure are being inappropriately and unnecessarily prescribed a combination blood pressure medications, a team of Canadian researchers warns.

And, they caution, the often unwarranted dual protocol can have serious consequences: an increased risk for kidney failure and even death.

The two types of drugs in question are angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs).

On their own, each is well established and highly effective for controlling blood pressure, the study team stressed. Also, a small number of people -- those diagnosed with a particular blood pressure issue related to improper left ventricular systolic function -- may derive some added benefit from taking the two medications concurrently, they say.

But most seniors do not need both drugs, the researchers contend, particularly given the fresh indication that there is usually far more to lose than gain.

"I'm not surprised that use of this combination of agents was often not guideline-based, as often the assumption is made that, if two drugs alone are beneficial, then the combination of the two must be even more beneficial," said the study's lead author, Dr. Finlay A. McAlister, from the division of general internal medicine and the Mazankowski Alberta Heart Institute at the University of Alberta in Edmonton, Canada.

But McAlister noted that research has already indicated that this is not the case with the mixing of ACE inhibitors and ARBs, and the new study "confirms the risks of this combination." The findings were reported March 21 in the Canadian Medical Association Journal.

The research involved 32,312 people, all older than 65, who were taking either an ACE inhibitor alone, an ARB alone or a combination of the two.

The team noted that among the roughly 5
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