-blockers or diuretics. They concluded that compared to inactive sugar-pills, diuretics or beta-blockers slightly increase the risk of becoming diabetic, whereas ARBs or ACE-inhibitors significantly decrease the risk.
“Most other studies of the association between drugs used mostly for high blood pressure could have been confused by differences in the patients studied. By only including studies that used randomization to minimize and balance differences between those assigned to different antihypertensive drugs, and by using a novel technique that can attribute risk both between agents that have been directly compared, and those that compare the results indirectly, we can see differences that other techniques cannot,” said Elliott.
“Our ‘indirect comparisons’ are similar to the way oddsmakers in Las Vegas compute the point spread for Sunday’s Bears-Saints playoff game. Since the Bears and Saints haven’t played each other (i.e., a direct comparison) this season, one can compare the record of the Bears against those teams that the Saints have also played this season. We use a similar strategy to compare, for example, ACE-inhibitors vs. ARBs, which have not been compared directly in any clinical trial to date.”
The study is expected to be of greater interest in the United Kingdom than the United States, because the British National Institute of Health and Clinical Excellence issued a new set of guidelines about hypertension treatment for primary care physicians in June 2006 that are based on economic considerations. Because diabetics generate about 4 times the healthcare expenditures as non-diabetics, the new British guidelines recommend against using both a diuretic and a beta-blocker for the routine treatment of hypertension. In the United States, however, tradition and the 2003 national hypertension guidelines still recommend a diuretic as first-line treatment, and a beta-blocker only one of several acceptable second-line options. Page: 1 2 3 Related medicine news :1
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