All Blood Pressure Drugs Lower Risk of Heart Attack and Stroke

Any are better than no treatment at all, study shows

By Steven Reinberg
HealthDay Reporter

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THURSDAY, May 7 (HealthDay News) --Lowering blood pressure is essential for reducing the risk of heart disease and stroke, but which drugs are best has been a matter of debate.

Now, two new analyses attempt to answer that question.

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Their conclusions: For heart attacks, all antihypertensive drugs work, with the exception of angiotensin receptor blockers (ARBs), probably because there aren't enough studies to confirm their benefit. For stroke, all antihypertensive drugs were better than placebo, but diuretics, ARBs or calcium channel blockers were significantly better than beta blockers or angiotensin-converting enzyme (ACE) inhibitors. Both reports were presented Wednesday at the American Society of Hypertension's annual meeting, in San Francisco.

"Physicians and patients should be reassured that, based on all the world's literature, sliced and diced in many ways, subjected to two separate and distinct types of meta-analyses, antihypertensive drugs do reduce the risk of the two most feared endpoints related to hypertension: heart disease and stroke," said lead researcher Dr. William J. Elliott, a professor of preventive medicine, internal medicine and pharmacology at Rush Medical College in Chicago.

For the first study, Elliott's team analyzed data from 57 trials that looked at treatment for high blood pressure and the reduction of heart attack risk.

The researchers found that, except for ARBs, all drugs were significantly better than placebo or no treatment in lowering blood pressure and reducing the risk of heart disease. Among all the drugs, ACE inhibitors were slightly better, however, the difference was not statistically significant.

These findings confirm other research that has shown that ARBs may not be as effective at preventing heart attack as other blood pressure drugs, and that ACE inhibitors are especially effective at preventing heart disease. That benefit may be due to other effects of the drug, not just its ability to lower blood pressure, the researchers noted.

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