ASH: Best Practice Evolving in Hypertension Treatment

Medications have differential effects in preventing heart disease, heart attack, and stroke
By Rick Ansorge
HealthDay Reporter

THURSDAY, May 7 (HealthDay News) -- In patients with hypertension, optimal initial treatment may vary because some medications are better than others at reducing the risk of heart disease, heart attack and stroke, according to new data presented this week at the annual meeting of the American Society of Hypertension, held from May 6 to 9 in San Francisco.

William J. Elliott, M.D., of RUSH Medical College in Chicago, and colleagues conducted two meta-analyses of 25 comparative trials involving more than 398,000 subjects, performed since the last comprehensive meta-analysis of cardiovascular outcomes was published in 2003.

For heart disease and stroke prevention, the researchers found that all types of initial therapy were superior to placebo or no treatment. But they found that the newest class of antihypertensive drugs -- angiotensin receptor blockers (ARBs) -- has not yet been shown to be superior to placebo or no treatment for the prevention of heart attacks. They also found that an initial diuretic, ARB, or calcium channel blocker was a significantly better choice than a beta-blocker or angiotensin-converting enzyme inhibitor for the prevention of strokes.

"While these and other meta-analyses have limitations, they do provide insights beyond those of single trials, helping us to better and more critically contrast and compare different approaches," Elliott said in a statement. "Ultimately, we hope these results can improve our understanding of how to effectively treat hypertension and ultimately impact health outcomes positively."

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