Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Beta-blocker or calcium antagonist-based therapies equally effective in treating hypertension

03.12.2003


Hypertensive patients with coronary artery disease had similar outcomes when they took a beta-blocker therapy or a calcium antagonist-based therapy, according to a study in the December 3 issue of The Journal of the American Medical Association (JAMA).



According to background information in the article, despite conclusive evidence of the effectiveness of medications to treat high blood pressure in patients with hypertension in general, safety and efficacy of antihypertensive medications in patients with coronary artery disease (CAD) have been discerned only from the analyses of subgroups in large trials.

Carl J. Pepine, M.D., of the University of Florida College of Medicine, Gainesville, Fla., and colleagues designed a randomized trial, the International Verapamil-Trandolapril Study (INVEST), to compare outcomes in older hypertensive patients with CAD treated with a calcium antagonist strategy (CAS; verapamil sustained release [SR]) or a beta-blocker, non-calcium antagonist strategy (NCAS; atenolol). Because most hypertensive patients require more than 1 agent to adequately control blood pressure, INVEST was intended to compare multidrug strategies rather than individual agents. The study included 22,576 hypertensive CAD patients aged 50 years or older, and was conducted September 1997 to February 2003 at 862 sites in 14 countries.


The medications trandolapril and/or hydrochlorothiazide were administered to achieve blood pressure goals according to guidelines from the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) of less than 140 mm Hg (systolic) and less than 90 mm Hg (diastolic); and less than 130 mm Hg (systolic) and less than 85 mm Hg (diastolic) if diabetes or renal impairment was present. Trandolapril was also recommended for patients with heart failure, diabetes, or renal impairment.

After an average follow-up of 2.7 years per patient, 2,269 patients had a primary outcome event (death, nonfatal heart attack, or nonfatal stroke) with no statistically significant difference between treatment strategies (9.93 percent in CAS and 10.17 percent in NCAS). Two-year blood pressure control was similar between groups. The JNC VI blood pressure goals were achieved by 65.0 percent (systolic) and 88.5 percent (diastolic) of CAS patients and 64.0 percent (systolic) and 88.1 percent (diastolic) of NCAS patients. A total of 71.7 percent of CAS patients and 70.7 percent of NCAS patients achieved a systolic blood pressure of less than 140 mm Hg and diastolic blood pressure of less than 90 mm Hg.

"In conclusion, our results indicate that lower targets for blood pressure control can be achieved in most hypertensive patients with CAD using a multidrug strategy that includes administration of angiotensin-converting enzyme (ACE) inhibitors to patients with heart failure, diabetes, or renal impairment. The clinical equivalence of the CAS and NCAS groups in prevention of death, [heart attack], or stroke supports the use of either strategy in clinically stable patients with CAD who require blood pressure control. The decision regarding which drug classes to use in specific CAD patients should be based on additional factors including adverse experiences, history of heart failure, diabetes risk, and the physician’s best judgment," the authors write.

Melanie Fridlross | EurekAlert!
Further information:
http://jama.com/

More articles from Health and Medicine:

nachricht Organ-on-a-chip mimics heart's biomechanical properties
23.02.2017 | Vanderbilt University

nachricht Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Stingless bees have their nests protected by soldiers

24.02.2017 | Life Sciences

New risk factors for anxiety disorders

24.02.2017 | Life Sciences

MWC 2017: 5G Capital Berlin

24.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>