Newer BP drugs no better than diuretics

As if questions about the effectiveness of cholesterol meds weren't enough, now research is casting blood pressure remedies into doubt. A new study in the Archives of Internal Medicine found that old-style diuretics did just as well as newer products at preventing heart attacks and death. Surprising results, the researchers said, because new drugs like alpha-blockers, calcium-channel blockers and ACE inhibitors lower cholesterol and blood glucose, while diuretics increase them. The researchers had assumed that the new drugs would be obviously better at staving off heart attacks, strokes, kidney disease, and heart failure, at least in high risk patients.

Not so. All three types of hypertension meds--which include Pfizer's Norvasc (newly off patent) and Cardura, Merck's Prinivil, and AstraZeneca's Zestril -- were no better than diuretics at preventing cardiac problems, end-stage renal disease, and death. In black patients, ACE inhibitors were less effective than the diuretics.

Meanwhile, the Vytorin dust-up has lots of folks looking at statins. Do they really improve patient outcomes? The answer is twofold, according to a story in the New York Times today: Yes, they lower cholesterol and cut the risk of heart attack, but they don't prolong life except in patients with established heart disease. Now, for those patients, that's a big deal. But, the experts said, there are probably plenty of people taking statins unnecessarily. Stay tuned for more debate.

- see the abstract from the Archives of Internal Medicine
- read the Wall Street Journal Health Blog item
- here's the statin story from The New York Times

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