Diuretics work better for high blood pressure

Study results by faculty members of the University of Texas School of Public Health at Houston suggests that the older, cheaper diuretics remain the drug of choice for both black and non-black patients in treating high blood pressure and reducing risk of heart disease, and confirms earlier findings that diuretics rather than newer, more expensive drugs such as ACE inhibitors, calcium channel blockers, or beta blockers should be preferred as a first therapy for most patients.

The analysis by race of the "Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial" (ALLHAT) study, was conducted under a National Institutes of Health contract with the University of Texas Health Science Centre.

Barry R. Davis, M.D., Ph.D., professor of biostatistics in the UT School of Public Health is the Principal Investigator and he and faculty members are co-authors of an article in the April 6 issue of The Journal of the American Medical Association.

Davis, who also is director of the Coordinating Centre for Clinical Trials at the UT School of Public Health, says it was questioned whether the diuretics' success with hypertension applied by race because black patients have less success than non-black patients with the ACE inhibitors, but the results showed diuretics were as good or better than the newer drugs regardless of race.

The group found that diuretics are similar to or superior to newer drugs in lowering blood pressure, in tolerability and in preventing the major complications from high blood pressure. Across both racial subgroups, there was substantially higher risk of heart failure - 37 percent - among participants taking calcium channel blockers compared with those on diuretics. When compared to ACE inhibitors, diuretics were more effective in preventing cardiovascular disease, especially heart failure, for all participants and significantly more effective in reducing high blood pressure and preventing stroke in blacks.

Davis says the findings confirms that diuretics should be the preferred initial therapy for high blood pressure.