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LITTLE ROCK - The results of a
giant international eight-year study of treatments for high blood
pressure should be good news for the 28 percent of Arkansans with
the condition, experts at the University of Arkansas for
Medical Sciences (UAMS) said today.
UAMS participated in the study,
which found that less costly, traditional diuretics work better
than newer medicines to treat high blood pressure and prevent some
forms of heart disease.
High blood pressure, or
hypertension, is a particularly serious threat to Arkansans, who
suffer at very high rates from the condition and related health
problems that cause heart disease, including diabetes, obesity,
and nicotine addiction, according to Dean James M. Raczynski,
Ph.D., of the UAMS College of Public Health. Unmanaged high blood
pressure, or hypertension, significantly increases their risk of
heart attack and sudden death.
Dr. Debra L. Simmons led UAMS
participation in the "ALLHAT," or Antihypertensive and
Lipid-lowering Treatment to Prevent Heart Attack Trial, which
culminates in a report to appear tomorrow in the "Journal of
the American Medical Association." The National Heart, Lung
and Blood Institute sponsored the ALLHAT study of 42,418
participants at 623 locations in the United States, Canada, Puerto
Rico, and the U.S. Virgin Islands.
Volunteers in the study all had
high blood pressure and at least one additional risk factor for
heart disease, such as cigarette smoking or type 2 diabetes.
"Diuretics should be the first
step in treating high blood pressure for almost all
patients," Simmons observed. "Many patients will need
more than one drug, but almost all will benefit from a
diuretic," she said.
"This finding that the less
expensive alternative truly is the best first step in managing
high blood pressure is good news for Arkansans, who are more
likely to suffer from high blood pressure and related problems
that cause heart attacks and strokes, and are also more likely to
find it difficult to pay for expensive medications,"
Raczynski of the College of Public Health said.
Simmons stressed that patients
should not stop taking their current medications for high blood
pressure before consulting their physicians.
Simmons leads the Arkansas Diabetes
Program at UAMS, which provides continuing medical education to
physicians around the state, emphasizing the importance of
regularly monitoring the health of persons with diabetes. Since
1992, the UAMS program has helped Arkansans manage diabetes in and
prevent or retard the progression of diabetes-related
complications. Its multidisciplinary team of endocrinologists,
diabetes nurse educators, diabetes nutrition specialists and
podiatrists provide intensive, very personalized support for
patients.
"ALLHAT shows that diuretics
are the best choice to treat hypertension and reduce the risk of
its complications, both medically and economically,"
according to Dr. Claude Lenfant, director of the National Heart,
Lung and Blood Institute, which sponsored the study.
"Many of the newer drugs were
approved because they reduce blood pressure and the risk of heart
disease compared with a placebo," he continued. "But
they were not tested against each other. Yet, these more costly
medications were often promoted as having advantages over older
drugs, which contributed to the rapid escalation of their use.
Now, at last, we can make those needed comparisons and know which
blood pressure drug to choose to begin therapy."
According to the ALLHAT high blood
pressure article, diuretic use fell from 56 percent of
antihypertensive prescriptions in 1982 to 27 percent in 1992. The
article notes that, had the pattern not changed, antihypertensive
prescriptions for that period would have cost about $3.1 billion
less.
About 24 million Americans take
drugs to lower high blood pressure, at an estimated annual cost of
about $15.5 billion, the article states.
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Note to Editors:
A companion news release about the ALLHAT study from the National
Heart, Lung, and Blood Institute is available here: http://www.nhlbi.nih.gov/new/press/02-12-17.htm
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