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New Drugs Found No More Effective Against High Blood Pressure Than Old Medicine - 2002-12-17

A study finds that an old drug is as effective as newer drugs in lowering blood pressure and reducing the risk of heart disease.

It is estimated that millions of people around the world suffer from high blood pressure, a condition in which the heart works harder than it should to pump blood through the arteries. High blood pressure can lead to a fatal heart attack.

For years, experts have debated which drugs are best for reducing high blood pressure, the newer ACE inhibitors and calcium channel blockers, or old standby drugs known as diuretics.

Known as water pills, diuretics remove salt and water in the blood stream so there's less pressure on the arteries leading away the heart. Both calcium channel blockers and ACE inhibitors open up constricted arteries through different mechanisms.

Researchers set out to answer the question by comparing diuretics to the newer drugs in a six year, nationwide study of more than 33,000 patients with at least one risk factor for coronary heart disease.

Dr. Paul Welton of Tulane University Health Sciences Center participated in the multicenter trial. "The major finding of our study was that none of the newer drugs to lower blood pressure seem to be particularly better than the traditional diuretic in preventing against heart attacks," Dr. Welton said.

The results of the study are published in the current issue of the Journal of the American Medical Association.

In a commentary in the Journal, Dr. Lawrence Appel of Johns Hopkins University in Baltimore, Maryland, said it appears the most effective therapy is also the least expensive because diuretics have been around for a long time.

"The cost per pill is roughly one to three cents per pill in contrast to a dollar or more per pill for some of the more expensive medicines that are currently available," Dr. Appel said.

Dr. Appel adds the results of the study may encourage doctors to prescribe diuretics more often for their patients with hypertension. But then again maybe not, since he says the drugs are no longer aggressively made and promoted by large pharmaceutical companies.