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    Lotrel Cuts Heart, Stroke, Death Risk

    Combination Blood-Pressure Tablet Beats Older Combo Drug in Trials
    WebMD Health News
    Reviewed by Louise Chang, MD

    March 31, 2008 (Chicago) -- A tablet that contains two different types of blood-pressure-lowering medications cuts the risk of heart attack, stroke, or death by one-fifth, when compared with an older combination drug, researchers report.

    The drug, Lotrel, proved so effective at preventing cardiovascular disease and deaths that the study was halted early so all patients could be offered it.

    "It's a clear win," says study researcher Kenneth Jamerson, MD, professor of internal medicine at the University of Michigan Medical School.

    The study compared two combination pills, both of which contain the angiotensin-converting enzyme (ACE) inhibitor Lotensin. Lotrel combines Lotensin and the calcium channel Norvasc. The other pill contained Lotensin and a diuretic called hydrochlorothiazide.

    1 in 3 Americans Have High Blood Pressure

    People whose systolic numbers (that's the top number in your blood pressure reading) are 140 or higher or whose diastolic numbers (the bottom number) are 90 or higher are considered to have high blood pressure. One in three people, or more than 73 million Americans, fit the bill.

    Often treatment begins with diet and exercise. If the blood pressure goal is not achieved, diuretics are commonly prescribed as the initial therapy for patients, either alone or in combination with another class of blood pressure-lowering medication.

    Jamerson says the findings "should modify future guidelines for the treatment of hypertension," both in terms of starting with a one-drug strategy in some patients and starting with diuretics.

    He notes that many patients find it more convenient to take a single-tablet combination of drugs rather than a handful, or even a couple, of different pills.

    Combos Lowered Blood Pressure

    The new study involved more than 11,000 people over 60 who had high blood pressure and other cardiovascular disease risk factors, such as obesity or diabetes.

    Only 37% of participants had adequate blood pressure control at the start of the study.

    By 36 months later, the average blood pressure in 80% of patients in both groups was less than 140 over 90, which is "excellent," Jamerson says.

    Importantly, patients taking Lotrel were 20% less likely to die from cardiovascular disease, have a heart attack or stroke, be hospitalized for the chest pain of angina, or need a procedure to open blocked heart arteries.

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