Least Expensive Treatment Also Most Effective In Hypertension

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(Last updated 12/19/02)

Previous stories pertaining to Professor Murden's research:

"Doctor, Patient Age Affect Input In Medical Decisions," 4/23/97.

"Weight Loss Linked To Death In Nursing Homes," 3/27/96.

LEAST EXPENSIVE TREATMENT ALSO MOST EFFECTIVE IN HYPERTENSION

COLUMBUS, Ohio – A major national study has shown that diuretics, the least expensive medication option available for the treatment of high blood pressure, are also the most effective in lowering patients’ blood pressure and are particularly good at preventing strokes and heart failure compared to the other drugs in the study. The results were published in this week’s issue of the Journal of the American Medical Association.

The clinical trial monitored 33,357 participants age 55 or older for between four and eight years, comparing the incidence of coronary heart disease or other cardiovascular disease in patients taking one of three of the most accepted treatments for hypertension: a calcium channel blocker, an angiotensin-converting enzyme (ACE) inhibitor or a thiazide-type diuretic.

“The enormity of this study is important because the sample included very large numbers of elderly individuals, African Americans and patients with diabetes, all subgroups of the American population who are typically at high risk for hypertension,” said Dr. Robert Murden of Ohio State University’s department of internal medicine, who led OSU Medical Center’s participation in the multicenter trial. “That broad representation means these results can translate immediately into equally effective and more affordable treatment options for most patients requiring medication to control their high blood pressure.”

Murden, a general internist with a specialty in geriatric medicine, oversaw the monitoring of 67 patients in the study, which was sponsored by the National Heart, Lung, and Blood Institute.
Participating patients were men and women with stage 1 or stage 2 hypertension with at least one additional risk factor for coronary heart disease, including a previous heart attack or stroke, history of Type 2 diabetes, current cigarette smoking or cardiovascular disease. In the double-blind study, participants were randomly assigned to take either chlorthalidone (diuretic), amlodipine (calcium channel blocker) or lisinopril (ACE inhibitor). Among the participants, the mean age was 67; 47 percent were women; 35 percent were black; 19 percent were Hispanic; and 36 percent were diabetic.

Overall, study leaders determined that thiazide-type diuretics should be considered first for medication therapy in patients with high blood pressure, and thus are expected to be part of multiple-drug regimens for virtually all who require more than one medication to control their blood pressure. An estimated 50 million to 60 million people in the United States have hypertension.

“Clearly, this study has far-reaching implications for patients and health care professionals,” Murden said. “This clarifies many questions about anti-hypertensive drugs and gives us answers needed to provide optimal care to patients with high blood pressure.”

More information about the study is available on the Web at http://www.nhlbi.nih.gov/health/allhat/index.htm.

Contact: Emily Caldwell, Medical Center Communications, 614-293-3737 or
caldwell.151@osu.edu