Researchers from the University of Florida College of Medicine designed a randomized trial to compare two different treatments for hypertension in older patients.
Researchers say most patients require more than one medication to control their blood pressure, so this study was set up to look at multidrug strategies rather than individual drugs. The study found patients had similar outcomes when they took beta-blocker therapy or a calcium antagonist-based therapy.
The research included 22,576 hypertensive patients with coronary artery disease. The study was conducted over five years at 862 sites in 14 countries. The blood pressure goals were less than 140 millimeters of mercury (systolic) and less than 90 millimeters of mercury (diastolic). The goals for patients with diabetes or renal impairment were less than 130 millimeters of mercury (systolic) and less than 85 millimeters of mercury (diastolic). The patients were treated with a calcium antagonist strategy (CAS) or a non-calcium antagonist strategy (NCAS).
Researchers reported that after two years the blood pressure goals that were achieved were similar between the two groups. In the CAS patients, 65 percent of patients achieved the systolic goal compared with 64 percent of the patients in the NCAS group. Similarly, 88.5 percent of the CAS patients reached the diastolic goal and 88.1 of the NCAS patients reached the desired diastolic goal. There was also no significant difference in the number of deaths, heart attack or strokes that occurred in the two groups.
Researchers conclude this study supports the use of either strategy to lower blood pressure in patients with coronary artery disease. They also say the study shows that lower targets for blood pressure control can be achieved by using a multidrug strategy.