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A Better Blood-Pressure Drug

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WebMD Health News
Reviewed by Gary D. Vogin, MD

March 20, 2002 (Atlanta) -- Not all blood-pressure drugs are alike. An exciting new study shows that Cozaar reduces the risk of stroke, heart attack, and death in seriously ill heart patients.

And that's not all: the drug also cuts the risk of diabetes in heart patients. For heart patients who already have diabetes, the drug lowers the risk of death.

Treatment with Cozaar reduced the risk of death from stroke by one-fourth. It dropped the risk of death by all causes by 13%. Study leader Björn Dahlöf, MD, reported the findings here at the annual meeting of the American College of Cardiology. The study also appears in the current issue of the journal The Lancet.

"We have known for many years that it is good to lower blood pressure. Now we show that it matters how we lower it," says Dahlöf, a researcher at the University of Götenborg, Sweden. "And there was also a very interesting and impressive result: New onset diabetes occurred at a 25% lower rate in patients treated with Cozaar."

The huge international trial compared Cozaar and Tenormin as part of treatment for people with high blood pressure and a serious heart condition known as left ventricular hypertrophy. The study looked at more than 9,000 patients ranging in age from 55 to 80. Half received Cozaar and half received Tenormin as part of their treatment. Neither the patients nor their doctors knew which drug they were getting. The researchers followed the patients for at least four years.

"What are the public health implications? Nearly 4 million people in the U.S. are over age 55 with high blood pressure," Dahlöf says. "If they were all put on this drug, every year there would be 70,000 fewer cases of heart death and 66,000 fewer strokes."

Dahlöf's report received a loud and lasting ovation from the crowd of heart doctors gathered to hear his presentations. Such demonstrations are very rare at medical meetings. Joining in the praise was Mayo Clinic researcher David R. Holmes Jr., MD.

"This is a tremendous clinical trial," Holmes said. He asked Dahlöf whether patients with coronary artery disease might benefit from taking both Cozaar and a beta-blocker. Dahlöf says that while the study did not test this idea, the combination of Cozaar and a beta-blocker has been tested and results are promising.

Cozaar is a type of drug known as an angiotensin receptor blocker or ARB. It is expected to show the same superiority to other beta-blockers -- Betapace, Blocadren, Brevibloc, Corgard, Inderal, Sectral, Toprol, and Zebeta. It's not yet known whether other ARBs -- Atacand, Avapro, Diovan, Micardis, and Teveten -- will work as well. However, an editorial in TheLancet suggests that it is reasonable to expect that they will.

Despite the welcome findings, treatment for heart patients still has a long way to go. Even the patients who took Cozaar had a one-in-10 chance of death from heart disease, stroke, or heart attack.

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