Maintaining a normal blood pressure is essential in the prevention of heart disease and is controlled by antihypertensive drugs, say researchers. Dr Jan Staessen and colleagues from Leuven, in Belgium, set out to determine whether it is the pharmacological properties of antihypertensive drugs or the reduction of blood pressure that accounts for the cardiovascular outcome in hypertensive patients.
As part of a meta-analysis the team compared blood pressure reducing drug treatments in 136,124 patients from 27 studies. When comparing the different drugs used in treatment they found that calcium-channel blockers and ACE inhibitors provided the same overall protection against cardiovascular complications as diuretics or ß-blockers.
However, calcium-channel blockers were found to be more protective against stroke than against myocardial infarction - resulting in an overall cardiovascular benefit similar to that of old classes of antihypertensive drugs. The authors concluded that, although calcium-channel blockers were effective in stroke prevention, they did not find that converting-enzyme inhibitors or alpha-blockers affected cardiovascular prognosis beyond their antihypertensive effects.
However, they say their findings indicate the desirability of lowering blood pressure as much as possible to achieve the greatest reduction in cardiovascular complications. The team also specified that on average all antihypertensive drugs had similar long-term efficacy and safety.