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Hypertension/High Blood Pressure Health Center

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Older Hypertension Medications Best

Several Studies Show Diuretics to Be Single Best Hypertension Medication
WebMD Health News

May 20, 2003 -- Another major study has found that the oldest and cheapest hypertension medications work better than newer and pricier hypertension medications. In a review of more than 40 trials involving almost 200,000 people, low-dose diuretics consistently performed as well as or better than other hypertension medications.

Study authors say the findings confirm that diuretics should be considered the first choice of treatment for preventing complications of high blood pressure, including heart attack, heart failure, and stroke. The study comes less than a week after a government panel made a similar recommendation but also stated that most people will need two or even three different medications to control their hypertension.

"I believe high blood pressure patients should be started on diuretics, and, if they aren't on them, they should be switched," lead researcher Bruce M. Psaty, MD, PhD, tells WebMD. "I think patients need to be asking their doctors why they aren't on the most effective drugs, which also happen to be the least expensive."

Some 50 million Americans have high blood pressure, but only about a third know they have it. About 15% of people with high blood pressure are on no treatment, more than 25% are using inadequate treatment, and less than a third are on adequate hypertension medications. It is estimated that 25% of adults have high blood pressure.

In their study, published in the May 21 issue of TheJournal of the American Medical Association, Psaty and colleagues from the University of Washington in Seattle compared data from 42 clinical trials using a unique system of analysis developed at the institution. The researchers were able to compare cardiovascular outcomes among people taking all the major hypertension medications -- diuretics, ACE inhibitors, beta-blockers, calcium channel blockers, angiotensin receptor blockers, and alpha-blockers.

None of the newer treatment classes were significantly better than low-dose diuretics for preventing illness or other complications.

Beta-blockers have been widely considered to be a first-line high blood pressure treatment in the past, but they were found to be less effective than diuretics for all measured cardiovascular outcomes.

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