MOST HYPERTENSION DRUGS, EXCEPT ARBs, BETTER THAN NO TREATMENT FOR CHD RISK REDUCTION

The American Society of Hypertension is meeting in San Francisco this week. One of the papers presented was this one by Dr William Elliot from Rush-Chicago. He and his team did a meta-analysis ( nowadays thats the way to go to save R&D money, and also guarantee a favourable outcome ) of the many hypertension trials after JNC 7. The meta-analysis included 276,000 patients who had hypertension as an entry criteria, and as long as they were on treatment, be it diuretic, beta-blockers, ACE-I or CCB, they did better then those not on treatment or those on placebo. Interestingly, the analysis on those who were hypertensives and taking ARBs ( the new kid on the block ) when compared against placebo, showed no advantage. Meaning that ARBs for hypertension, did not seem to protect the ptients against CV events ( surprisingly ). The authors explained that this may be because, the trials on ARBs included in their analysis, were smaller ARB trials and so the small number may have cause them to lose their statistical power to show a difference. It must be noted that the large ARB trials that we know ( including ONTARGET, with a patient enrolment of 27,000 , were in people at high risk of CV events in CHD and not strictly for hypertension ).
This finding, that treatment for hypertension with drugs ( whichever you chose, except ARBs ), will protect against cardiac events was also true for strokes. So treatment of hypertension, with whichever drug ( except ARBs ) will reduce stroke.
The gist of this is that treat hypertension. Chose whichever drug you or your doctor wish. Be compliant. You will be protected against CV events and stroke. Of course, the better the BP control ( treat to target ) the more the benefit and protection. In fact, baring side effects, the lower the BP the better, I believe.
TREATING HYPERTENSION, SAVES LIVES.