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Newer Blood Pressure Drugs Beat Out Older Ones

Findings Contradict Previous Studies Showing Older Is Better
By
WebMD Health News

Sept. 6, 2005 (Stockholm, Sweden) -- Tens of thousands of heart attacks, strokes, and deaths could be prevented each year if people took a combination of newer high blood pressure drugs rather than the old standbys.

Additionally, the newer regimen may cut the risk of diabetes by about one-third, says researcher Bjorn Dahlof, MD, associate professor of medicine at the University of Goteborg in Sweden.

"The more modern therapy fared better than the older treatment in almost every regard," he tells WebMD.

Is Newer Really Better?

The new study does not agree with previous research showing that water pills (diuretics) were better at preventing heart failure and stroke than newer blood pressure drugs.

A landmark trial in 2002 showed that compared with the cheaper diuretic, people taking Norvasc had a 38% higher risk of developing heart failure and a 35% higher chance of being hospitalized with heart failure. Those on an ACE inhibitor, also a newer class of drugs, had a 15% higher risk of stroke, a 19% higher risk of developing heart failure, and other increased risks compared with people taking a diuretic.

In response to those previous findings, experts told WebMD in 2002 that doctors should begin drug treatment for high blood pressure with a diuretic.

Drugs Battle It Out

The new study, presented here at the annual meeting of the European Society of Cardiology, included more than 19,000 people with high blood pressure and at least three other heart disease risk factors, such as smoking and family history.

About half got Norvasc -- a member of the newer class of drugs known as calcium-channel blockers -- while the rest got atenolol, an older drug belonging to the class called beta-blockers. The study was funded by Pfizer, which manufacturers Norvasc. Pfizer is a WebMD sponsor.

If either of the drugs failed to lower blood pressure, another medication was added: People on Norvasc were also given the ACE inhibitor Aceon, while those on atenolol added a diuretic.

After 5.5 years, the trial was stopped prematurely when results showed the Norvasc-based treatment beat out the older approach: They were 23% less likely to have a stroke, 11% less likely to die, and 30% less likely to develop diabetes than people who took the beta-blocker. Both regimens were equally safe.

Additionally, 32% of the people with diabetes and 60% of those without diabetes achieved their blood pressure goals: less than 140/90 for patients without diabetes and 130/80 for patients with diabetes.

The study was simultaneously published online in The Lancet.

Blood Pressure or Something Else?

But overall, people who took Norvasc achieved blood pressures that were only about three points lower than those on beta-blockers, setting off a debate about whether blood pressure lowering or other factors are at play.

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