Debate: Does it matter how you lower blood pressure? Academic Article uri icon

Overview

abstract

  • Whether it matters how pressure is lowered has been debated since antihypertensive drugs proved to prevent cardiovascular events. However, in clinical trials, while the stroke benefit predicted by a given difference in blood pressure was achieved, the results for myocardial infarction were roughly half that expected. This suggested that adverse drug effects of diuretics and beta-blockers might have detracted from their hypotensive effects. Trials with newer antihypertensive classes have revealed superior effects on outcomes associated with converting enzyme inhibitor use, and that alpha-blockers are less cardioprotective than diuretics. These studies establish that simple blood pressure reduction is an inadequate guide to therapy. The challenge now will be to determine the optimal therapy for each hypertensive patient.

publication date

  • January 1, 2000

Identity

PubMed Central ID

  • PMC59601

Scopus Document Identifier

  • 0034688194

Digital Object Identifier (DOI)

  • 10.1056/NEJM200001203420301

PubMed ID

  • 11714412

Additional Document Info

volume

  • 1

issue

  • 2