Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Diabetics with high blood pressure benefit from ’water pills’

28.06.2005


Diuretics (water pills) work better than newer and more costly medicines in the treatment of high blood pressure and prevention of some forms of heart disease in people with type 2 diabetes, according to results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). ALLHAT, the largest hypertension clinical trial ever conducted, was led in part by Tulane University physician and epidemiologist Paul K. Whelton, senior vice president for health sciences and lead author for the current report published in the June 27th issue of the Archives of Internal Medicine.

"Almost three out of every four persons with type 2 diabetes has hypertension, putting them at substantial risk for cardiovascular disease," Whelton says.

An important question in patients with type 2 diabetes and hypertension has been whether it makes a difference which medicine is used for initial therapy of high blood pressure.



"ALLHAT is the largest study to address this question, comparing four different classes of antihypertensive medication: diuretics, angiotensin-converting enzyme [ACE] inhibitors, calcium channel blockers and alpha receptor blockers," Whelton says.

In an earlier publication (Journal of the American Medical Association, December 2002), the ALLHAT investigators reported that diuretics were superior in preventing adverse cardiovascular disease outcomes compared with other first-step antihypertensive medications. The current report indicates that this is true not only in hypertensive patients with a normal blood sugar, but in those with diabetes, or an impaired fasting glucose (pre-diabetes).

The Archives publication was based on long-term clinical trial experience in 31,512 men and women who were all 55 years old or older with stage 1 or stage 2 hypertension and at least one additional risk factor for coronary heart disease. Study participants were assigned to initial treatment with either a calcium channel blocker (amlodipine), an ACE inhibitor (lisinopril) or a diuretic (chlorthalidone). Compared with the ACE inhibitor and the calcium channel blocker, the diuretic was:

  • More protective against heart failure in patients with or without diabetes (by about 1/6th compared with the ACE inhibitor, and by about 1/3rd compared with the calcium channel blocker).
  • More protective against stroke in people with or without diabetes (compared with the ACE inhibitor). This benefit was seen only in Black patients.
  • Slightly more effective in lowering systolic blood pressure-the measure of blood pressure when the heart beats-among those with or without diabetes.
  • At least equally protective against fatal coronary heart disease or non-fatal heart attacks in diabetics, those with an impaired fasting glucose, and in those with a normal blood sugar.
  • Equally protective against death, end-stage renal disease or cancer in diabetics, those with an impaired fasting glucose, and in those with a normal blood sugar.

"Independent of diabetes status, our results suggest that diuretics are better than ACE inhibitors and calcium channel blockers in preventing certain cardiovascular disease complications-especially heart failure-during initial treatment of high blood pressure. Patients with diabetes and high blood pressure should not change their antihypertensive medications without discussing this option with their doctors," says Whelton.

Madeline Vann | EurekAlert!
Further information:
http://www.tulane.edu

More articles from Health and Medicine:

nachricht Cholesterol-lowering drugs may fight infectious disease
22.08.2017 | Duke University

nachricht Once invincible superbug squashed by 'superteam' of antibiotics
22.08.2017 | University at Buffalo

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: Fizzy soda water could be key to clean manufacture of flat wonder material: Graphene

Whether you call it effervescent, fizzy, or sparkling, carbonated water is making a comeback as a beverage. Aside from quenching thirst, researchers at the University of Illinois at Urbana-Champaign have discovered a new use for these "bubbly" concoctions that will have major impact on the manufacturer of the world's thinnest, flattest, and one most useful materials -- graphene.

As graphene's popularity grows as an advanced "wonder" material, the speed and quality at which it can be manufactured will be paramount. With that in mind,...

Im Focus: Exotic quantum states made from light: Physicists create optical “wells” for a super-photon

Physicists at the University of Bonn have managed to create optical hollows and more complex patterns into which the light of a Bose-Einstein condensate flows. The creation of such highly low-loss structures for light is a prerequisite for complex light circuits, such as for quantum information processing for a new generation of computers. The researchers are now presenting their results in the journal Nature Photonics.

Light particles (photons) occur as tiny, indivisible portions. Many thousands of these light portions can be merged to form a single super-photon if they are...

Im Focus: Circular RNA linked to brain function

For the first time, scientists have shown that circular RNA is linked to brain function. When a RNA molecule called Cdr1as was deleted from the genome of mice, the animals had problems filtering out unnecessary information – like patients suffering from neuropsychiatric disorders.

While hundreds of circular RNAs (circRNAs) are abundant in mammalian brains, one big question has remained unanswered: What are they actually good for? In the...

Im Focus: RAVAN CubeSat measures Earth's outgoing energy

An experimental small satellite has successfully collected and delivered data on a key measurement for predicting changes in Earth's climate.

The Radiometer Assessment using Vertically Aligned Nanotubes (RAVAN) CubeSat was launched into low-Earth orbit on Nov. 11, 2016, in order to test new...

Im Focus: Scientists shine new light on the “other high temperature superconductor”

A study led by scientists of the Max Planck Institute for the Structure and Dynamics of Matter (MPSD) at the Center for Free-Electron Laser Science in Hamburg presents evidence of the coexistence of superconductivity and “charge-density-waves” in compounds of the poorly-studied family of bismuthates. This observation opens up new perspectives for a deeper understanding of the phenomenon of high-temperature superconductivity, a topic which is at the core of condensed matter research since more than 30 years. The paper by Nicoletti et al has been published in the PNAS.

Since the beginning of the 20th century, superconductivity had been observed in some metals at temperatures only a few degrees above the absolute zero (minus...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Call for Papers – ICNFT 2018, 5th International Conference on New Forming Technology

16.08.2017 | Event News

Sustainability is the business model of tomorrow

04.08.2017 | Event News

Clash of Realities 2017: Registration now open. International Conference at TH Köln

26.07.2017 | Event News

 
Latest News

ShAPEing the future of magnesium car parts

23.08.2017 | Automotive Engineering

New insights into the world of trypanosomes

23.08.2017 | Life Sciences

New Test for Rare Immunodeficiency

23.08.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>