Current national guidelines recommend that blood pressure be kept below 140/90 millimeters of mercury for the general population, and less than 130/80 for people with diabetes or chronic kidney disease. Hypertension increases the risk of coronary heart disease, heart attack and stroke.
The study included at least 100 hypertensive patients in specific subgroups: those age 65 and older, African-Americans, Hispanic/Latinos, and people with Type 2 diabetes. Patients with several risk factors for cardiovascular disease were also included, such as obesity, abnormal glucose tolerance, high triglycerides and low high-density lipoprotein, the so-called "good" cholesterol. According to Dr. Saunders, all of these subgroups represent a large part of the hypertensive population in the U.S. They may require two or more medicines to reach a desirable blood pressure goal.
Dr. Saunders says the medication was the only factor being tested in the study. There was no effort to adjust diet or exercise, which can also control blood pressure. "It is fair to say that this control was almost solely due to the drug therapy," says Dr. Saunders.
The patient subgroups in the study showed similar results. For example, in the older group of people age 65 and over, the mean systolic blood pressure at the start of the trial was 157. At the end of ten weeks, average systolic blood pressure was down 14.9 points. At the conclusion of the study at week 18, after patients had received a higher dose of the combination medicine, their systolic readings had dropped an average of 23 points, to 134.
In the African-American subgroup, blood pressure dropped 20.7 points by the end of the study to an average systolic reading of 135.2.
The Hispanic/Latino subgroup had a d
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Contact: Bill Seiler
bseiler@umm.edu
410-328-8919
University of Maryland Medical Center
17-May-2005