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Calcium-channel blockers and hypertension

NEW YORK, July 31 (Praxis Press) Cardiovascular outcomes have not been compared in hypertensive patients treated with calcium channel blockers and in patients treated with older drugs. Hansson and colleagues compared morbidity and mortality in 5,410 hypertensive patients randomized to diltiazem treatment and in 5,471 hypertensive patients randomized to treatment with diuretics, beta-blockers, or both. Both regimens effectively lowered systolic and diastolic blood pressure, although diuretics an

August 1, 2000

NEW YORK, July 31 (Praxis Press) Cardiovascular outcomes have not been compared in hypertensive patients treated with calcium channel blockers and in patients treated with older drugs. Hansson and colleagues compared morbidity and mortality in 5,410 hypertensive patients randomized to diltiazem treatment and in 5,471 hypertensive patients randomized to treatment with diuretics, beta-blockers, or both. Both regimens effectively lowered systolic and diastolic blood pressure, although diuretics and beta-blockers more markedly lowered systolic blood pressure (P < 0.001). The combined primary endpoint of all stroke, myocardial infarction, and other cardiovascular death occurred with similar frequencies in both groups (relative risk, 1.00; P = 0.97). In another study, Brown and colleagues compared outcomes in 3,157 hypertensive patients randomized to treatment with long-acting nifedipine and in 3,164 hypertensive patients randomized to treatment with the diuretic combination co-amilozide. The combined primary outcome of cardiovascular death, myocardial infarction, heart failure, and stroke occurred with similar frequencies in both groups (relative risk, 1.10, P = 0.35). Discontinuation was more likely among nifedipine-treated patients (P < 0.0001) because of peripheral edema, but co-amilozide-treated patients were more likely to suffer serious adverse effects (P = 0.02). Nifedipine-treated patients had higher rates of non-fatal heart failure (P = 0.028) and fatal myocardial infarction (P = 0.017), although all-cause mortality was similar for the two groups (P = 0.81).

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