Use CCBs as last resort in treatment of hypertension
The Journal of Family Practice. 2005 March;54(3):199-206
March 1, 2005|The Journal of Family Practice
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- CLINICAL QUESTION: In the treatment of adults with hypertension, which other drug class added to diuretics most effectively reduces adverse cardiovascular events?
- STUDY DESIGN: Cohort (prospective)
- SETTING: Population-based
- SYNOPSIS: Evidence shows that diuretics are equal to or superior to other agents as first-line therapy for most patients with hypertension. More than 1 drug class, however, is frequently required to control hypertension. It is unclear which other drug classes, added to diuretics, optimally reduce adverse cardiovascular events.
BOTTOM LINE
In women with hypertension and no history of cardiovascular disease (CVD), a regimen of a diuretic plus either a beta-blocker or angiotensin-converting enzyme (ACE) inhibitor reduces the risk of CVD mortality compared with a diuretic plus calcium channel blocker. The evidence continues to mount that calcium channel blockers should be the agent of last resort in the treatment of most patients with hypertension. (LOE=2b–)
