Review: Commonly used antihypertensive therapies and targeted blood pressure-lowering regiments reduce cardiovascular events: COMMENTARY

McAlister, Finlay A.
May 2004
ACP Journal Club;May/Jun2004, Vol. 140 Issue 3, p72
Academic Journal
The prospective review by the Blood Pressure (BP) Lowering Treatment Trialists' Collaboration expands the ongoing debate about antihypertensive treatment choices. 11 of the 29 large trials included were truly "hypertension" trials, while many patients in the other 18 trials had concomitant hypertension and were recruited on the basis of comorbid conditions, resulting in lower mean baseline BP in the latter trials. This meta-analysis echoes the results of other work in this field and clearly establishes that lowering BP reduces cardiovascular risk, larger reductions in BP lead to greater reductions in risk for major cardiovasuclar agents (MCE), and differences in degree of BP lowering account for many of the differences in CV outcomes seen between drug classes in active-control trials. However, the effect of certain antihypertensive classes on cause-specific CV outcomes or in different patient subgroups.


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