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Two Drugs Better Than One for High Blood Pressure
Date:3/31/2008

Pairing ACE inhibitor with calcium channel blocker beat pairing it with diuretic; Celebrex study finds dose related to heart risk

MONDAY, March 31 (HealthDay News) -- A large trial shows that combining an ACE inhibitor with a calcium channel blocker in individuals with high blood pressure who are at high risk for cardiovascular complications resulted in a 20 percent reduction in the risks of death, heart attack, stroke and other cardiovascular troubles.

The ACE inhibitor and calcium channel blocker were combined in a single pill. Patients receiving this treatment were compared to patients who received an ACE inhibitor combined with a diuretic.

The authors of the study, which was halted early because the results were so strong, presented the interim results during a news conference Monday at the American College of Cardiology annual meeting, in Chicago. Their hope is that the findings will change current practice guidelines.

"This strategy challenges our current guidelines in two important ways. First, the idea that monotherapy [starting out on a single pill] should be the rule of stay is now challenged and, second, guidelines have recommended that we use a diuretic, and we show that an ACE inhibitor and calcium channel blocker are superior," said study author Dr. Kenneth Jamerson, a professor of internal medicine at the University of Michigan Medical School.

The trial randomized more than 10,000 individuals, two-thirds of whom came into the study with inadequately controlled blood pressure. The use of the combination tablet as the first line of treatment more than doubled the number of patients who managed to get their hypertension under control, the study authors said in a statement. Novartis, which is one of the companies offering the two-drug combination tablet, funded the study.

A second study presented at the news conference refines the safety profile for Celebrex, the only cox-2 painkill
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