ASCOT: a tale of two treatment regimens

doi:10.1136/bmj.331.7521.859

BMJ 2005;331:859-860 (15 October), doi:10.1136/bmj.331.7521.859

Editorial

ASCOT: a tale of two treatment regimens

Better blood pressure, fewer deaths, and less diabetes withnewer antihypertensive agents

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

Each year in the United Kingdom alone there are 20 000 preventabledeaths from cardiovascular disease attributable to hypertension.Much of the excess mortality and associated morbidity arisesfrom poor control of blood pressure among people known to havehypertension. For the past two years in the United Kingdom,general practitioners have had the prime responsibility fortackling this problem, along with financial incentives to meettargets for detecting and controlling high blood pressure. Yet,despite many clinical trials and guidelines, they may be unsureabout which antihypertensive drug to use first and how to combinetreatments.

In 2004 the National Institute for Health and Clinical Excellence(NICE) recommended thiazide or thiazide-like diuretics as thefirst line treatment for most patients, with the addition of ${beta}$ blockers as the next step.^w1 This echoed the advice given inthe US Joint National Committee's guidelines the previous year.^w2Near simultaneous guidance from . . . [Full text of this article]

Claire McDougall, NovoNordisk Research Foundation clinical research fellow

Division of Cardiovascular and Medical Sciences, Western Infirmary, Glasgow G11 6NT

Adrian J B Brady, consultant cardiologist

Queen Elizabeth Building, Glasgow Royal Infirmary, Glasgow G31 2ER

John R Petrie, reader in diabetic medicine

Division of Medicine and Therapeutics, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY (j.r.petrie@dundee.ac.uk)

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Rapid Responses:

Read all Rapid Responses

doxazosin: Harvey D Sanders
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Should we be second guessing NICE/BHS?: Matthew Robinson
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