Diuretics And Beta-Blockers Are Best Drugs To Combat High Blood Pressure, Study Finds

St. Louis, March 19, 1998 -- Physicians use a small arsenal of newer drugs -- including calcium channel blockers, ACE inhibitors and alpha-blockers -- to lower high blood pressure. But the results of a study published in the March issue of Hypertension show that two older, less expensive types of drugs,

diuretics and beta-blockers, may lower blood pressure even better. This study, coordinated by a hypertension specialist at Washington University School of Medicine in St. Louis, analyzed data from 6,100 veterans treated at six Hypertension Screening and Treatment Program (HSTP) clinics of the U. S. Department of Veterans Affairs.

"The regimens of diuretic or diuretic plus beta-blocker gave the lowest average pressures and calcium channel blockers the highest," says H. Mitchell Perry Jr., M.D., professor emeritus of medicine at the School of Medicine and Physician Coordinator for Hypertension for the U.S. Department of Veterans Affairs. "There is a big difference in regimen efficacy, and it is statistically significant even after we correct for age, race and geographic region."

The study involved veterans receiving outpatient care at HSTP clinics in St. Louis, Mo., Indianapolis, Ind., Iowa City, Iowa, Memphis, Tenn., Jackson, Miss.and San Juan, Puerto Rico. These physician-supervised clinics, staffed by nurses and physician assistants intensively trained in hypertension, were established in 1974 by the Veterans Administration, as it was then called.

The physician-coordinators and staff members were allowed to choose which antihypertensive regimen to follow. They also could decide how aggressively to pursue the HSTP-recommended diastolic blood pressure goal.

The 46-month hypertension study, which ran from May 1989 to February 1993, did not follow a traditional randomized model. Instead, it relied on "real-world" data collected from clinicians who were primarily interested in treating patie

Contact: Candace O'Connor
Washington University School of Medicine

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