New Debate on Some Blood Pressure Drugs
Study Compares Diuretics and Other Treatments for People With Metabolic Syndrome, High Blood Pressure
Jan. 28, 2008 -- Researchers say a new analysis questions the preferred use
of certain blood pressure medications over diuretics in people with metabolic syndrome.
The analysis shows thiazide diuretics worked as effectively at treating high blood pressure -- and in
some cases better -- than calcium channel blockers, ACE inhibitors, or
alpha-blockers in people at high risk for complications from high blood
pressure and metabolic syndrome.
The study was published in the Jan. 28 edition of Archives of Internal
Metabolic syndrome is defined as elevated blood pressure plus at least two
other risk factors, such as elevated fasting blood sugar and triglyceride
levels. Having metabolic syndrome puts you at increased risk for heart disease and diabetes. Those
with high blood pressure who also have metabolic syndrome are at high risk for
Researchers say that because alpha-blockers, ACE inhibitors, and calcium
channel blockers are believed to have favorable short-term effects on blood
sugar or cholesterol levels, they have been suggested for treating high blood
pressure in people with metabolic syndrome over diuretics.
(If you have metabolic syndrome, would you try diuretics
as a treatment? Why or why not? Talk about it on WebMD's
Hypertension Support Group message board.)
Diuretics for High Blood Pressure
In the study, Jackson T. Wright Jr., MD, PhD, of Case Western Reserve
University, and colleagues analyzed the results of a large national study
including 42,418 people at least 55 years old with high blood pressure and at
least one other risk factor for heart disease.
All participants had high blood pressure and some qualified for metabolic
syndrome. Groups were randomly assigned to take a diuretic, calcium channel
blocker, alpha-blocker, or an ACE inhibitor. Each high blood pressure
medication was used to start treatment, and other drugs could be added if
needed to control blood pressure.
The participants were followed for nearly five years, except for the
alpha-blocker group, which was discontinued after about three years after
higher rates of stroke and heart failure were found compared
with those taking diuretics.
Overall, the results show no significant advantage in preventing heart attack or other fatal
heart-related complications with the use of calcium channel blockers,
alpha-blockers, or ACE inhibitors over thiazide diuretics in participants with
high blood pressure and metabolic syndrome. This was especially evident among
"These findings fail to provide support for the selection of
alpha-blockers, ACE inhibitors, or calcium channel blockers over thiazide-type
diuretics" to prevent cardiovascular problems in patients with metabolic
syndrome, the researchers conclude.