ACE inhibitors are better first choice than diuretics for elderly patients, study says
BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7386.415/b (Published 22 February 2003) Cite this as: BMJ 2003;326:415All rapid responses
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All time we try to ask : which class of drugs is best? I think that
is wrong question. All medication we can use as first line therapy. Very
important is only one question - hypertension control.
Competing interests:
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Competing interests: No competing interests
there is no best drug for the elderly. they have also co-morbid
conditions. it is best to individualise, taking into account renal
function, diabetes, obesity and other conditions like dyslipidaemia. only
after consideration of all these factors can a rational decision be made
as to the best drug to use in the elderly.
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None declared
Competing interests: No competing interests
Dear Sir,
It is curious that every time the "poor" diuretic is shown in good light,
we find fault with the study. Now it is the turn of the ALLHAT study.
If I remember right, when the V JNC report suggested diuretics as the
first line anti-hypertensives, similar criticism greeted the guidelines.
Consequently, JNC VI came out faster than usual.
Is there a hidden hand behind these? I could be wrong but it is only a
wild guess.
As in life and so in pharmaceuticals, rich always get the benefit, as per
the Mathew Law: "He who hath shall be given."
Poor pay for their poverty with their lives. May be, one day the "poor"
diuretics would die a natural death. It would be a sad day for patients,
though!
yours ever,
bmhegde
Competing interests:
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Competing interests: No competing interests
Which is a better choice?
The debate whether a diuretic is a better choice than an ace
inhibitor is futile.The choice depends on the clinical profile and the
comorbities of the patient. Since most patients require 2 or more
antihypertensive agents for optimal blood pressure control both classes of
drugs are complimentary.
Competing interests:
None declared
Competing interests: No competing interests