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MEDICINE Study suggests new drugs lower blood pressure better


Published: Sun, September 4, 2005 @ 12:00 a.m.


The findings contradict an earlier study and have prompted debate.
STOCKHOLM, Sweden (AP) -- A combination of newer medicines is better at lowering blood pressure and more effective at reducing the risk of heart attacks and strokes than the more traditional combination of drugs, major new research suggests.
However the findings, presented Sunday at the annual conference of the European Society of Cardiology, prompted debate because they contradict an earlier study that found traditional diuretic-driven therapy was superior to newer drugs.
Experts were divided over whether the results of the study -- led by Dr. Bjorn Dahlof of Sahlgrenska University Hospital in Goteborg, Sweden -- mean that the newer pills are themselves more effective or whether the extra benefit seen in the study reflects the possibility that patients getting the newer pills were more likely to take their medication properly because there are fewer side effects.
How research was done
The study compared the effects of two combinations of blood pressure medicine in 19,257 patients with hypertension, or high blood pressure.
About half the patients received the older combination: a beta blocker called atenolol to slow the heart rate and a diuretic to reduce fluid in the body. The other half received a pair of modern drugs: a calcium blocker called amlodipine to slow the rate at which the heart pumps blood, coupled with the ACE inhibitor perindopril, which lowers blood pressure by relaxing vessels.
After five years, the scientists found that those taking the modern combination had blood pressure levels on average 2.7 points lower than those taking the more traditional medication.
Heart attacks, strokes and new diagnoses of diabetes were also less common among those taking the newer drugs than in the traditional group. Strokes were down 23 percent, heart-related deaths were 24 percent lower and new diagnoses of diabetes were 30 percent lower among the patients who got the newer drugs.
There was no difference between the two groups when it came to complications.
The study was stopped prematurely after five years when preliminary results started to emerge because the safety committee believed the differences between the two groups was so large that it would be unethical to continue.
Doctors also raised questions over whether the heart attacks, strokes and deaths were lower with the newer drugs simply because blood pressure was lower in that group.


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