Findings of a meta-analysis published in this week’s issue of The Lancet emphasise that blood pressure control is important and that on average, all antihypertensive drugs have similar long-term efficacy and safety.
One of the most common causes of death in the developed world is cardiovascular disease (heart attacks and strokes). Measures to prevent cardiovascular disease include not smoking tobacco, not being overweight, and taking adequate exercise. It is also important that raised blood pressure (hypertension) be detected and adequately treated. It has been suggested that some of the drugs used to lower high blood pressure might have a beneficial effect on the cardiovascular system that does not depend on lowering blood pressure. Jan A Staessen and colleagues from Leuven, Belgium, analysed 27 trials of blood-pressure-reducing drug treatments involving 136 124 people to try to find an answer to this question.
They found that lowering high blood pressure is the important effect of all drug treatments, and there was little difference between the various drugs used over the years. The hypothesis that ACE (angiotensin converting enzyme) inhibitors might affect outcome beyond their blood-pressure-lowering effects remains unproved.
Contact : Dr Jan A Staessen, Studiecoördinatiecentrum, Laboratorium Hypertensie, Campus Gasthuisberg, Gebouw Onderwijs en Navorsing, Herestraat 49, B-3000 Leuven, Belgium. E) jan.staessen@med.kuleuven.ac.be
Journal
The Lancet