Drug treatment of hypertension

doi:10.1136/bmj.326.7392.764/a

BMJ 2003;326:764 ( 5 April )

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Drug treatment of hypertension

Conclusion of editorial is somewhat flawed

Thiazides with your pension?

Conclusion of editorial is somewhat flawed

The first 150 words of the full text of this article appear below.

EDITOR $---$ In his analysis of the major results of the recently published antihypertensive and lipid lowering treatment to preventheart attack trial (ALLHAT), Williams concludes that the key messagefrom this trial is that what matters most is getting blood pressurecontrolled and that this is overwhelmingly more important thanthe means. ¹ ²

ALLHAT showed that all blood pressure drugs were not "created" equally.² Williams correctly points out important differencesin the secondary cause specific end points between chlorthalidoneand its active comparators: doxazosin (increased congestive heartfailure), lisinopril (increased stroke and coronary end points),and amlodipine (increased stroke). For this very reason, the datasafety monitoring board of the ALLHAT trial recommended discontinuanceof the doxazosinarm.

There are other characteristics of blood pressure drugs, other than their effect on so called hard end points, that are asimportant as getting blood pressure controlled. These includecost, profile of . . . [Full text of this article]

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Drug treatment of hypertension: Bryan Williams
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