Findings on Blood Pressure Medicines Are “Good News” In Arkansas, UAMS Experts Say
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LITTLE ROCK – The results of a giant international eight-year study of treatments for high blood pressure should be good news for the 28 percent of Arkansans with the condition, experts at the University of Arkansas for Medical Sciences (UAMS) said today.
UAMS participated in the study, which found that less costly, traditional diuretics work better than newer medicines to treat high blood pressure and prevent some forms of heart disease.
High blood pressure, or hypertension, is a particularly serious threat to Arkansans, who suffer at very high rates from the condition and related health problems that cause heart disease, including diabetes, obesity, and nicotine addiction, according to Dean James M. Raczynski, Ph.D., of the UAMS College of Public Health. Unmanaged high blood pressure, or hypertension, significantly increases their risk of heart attack and sudden death.
Dr. Debra L. Simmons led UAMS participation in the “ALLHAT,” or Antihypertensive and Lipid-lowering Treatment to Prevent Heart Attack Trial, which culminates in a report to appear tomorrow in the “Journal of the American Medical Association.” The National Heart, Lung and Blood Institute sponsored the ALLHAT study of 42,418 participants at 623 locations in the United States, Canada, Puerto Rico, and the U.S. Virgin Islands.
Volunteers in the study all had high blood pressure and at least one additional risk factor for heart disease, such as cigarette smoking or type 2 diabetes.
“Diuretics should be the first step in treating high blood pressure for almost all patients,” Simmons observed. “Many patients will need more than one drug, but almost all will benefit from a diuretic,” she said.
“This finding that the less expensive alternative truly is the best first step in managing high blood pressure is good news for Arkansans, who are more likely to suffer from high blood pressure and related problems that cause heart attacks and strokes, and are also more likely to find it difficult to pay for expensive medications,” Raczynski of the College of Public Health said.
Simmons stressed that patients should not stop taking their current medications for high blood pressure before consulting their physicians.
Simmons leads the Arkansas Diabetes Program at UAMS, which provides continuing medical education to physicians around the state, emphasizing the importance of regularly monitoring the health of persons with diabetes. Since 1992, the UAMS program has helped Arkansans manage diabetes in and prevent or retard the progression of diabetes-related complications. Its multidisciplinary team of endocrinologists, diabetes nurse educators, diabetes nutrition specialists and podiatrists provide intensive, very personalized support for patients.
“ALLHAT shows that diuretics are the best choice to treat hypertension and reduce the risk of its complications, both medically and economically,” according to Dr. Claude Lenfant, director of the National Heart, Lung and Blood Institute, which sponsored the study.
“Many of the newer drugs were approved because they reduce blood pressure and the risk of heart disease compared with a placebo,” he continued. “But they were not tested against each other. Yet, these more costly medications were often promoted as having advantages over older drugs, which contributed to the rapid escalation of their use. Now, at last, we can make those needed comparisons and know which blood pressure drug to choose to begin therapy.”
According to the ALLHAT high blood pressure article, diuretic use fell from 56 percent of antihypertensive prescriptions in 1982 to 27 percent in 1992. The article notes that, had the pattern not changed, antihypertensive prescriptions for that period would have cost about $3.1 billion less.
About 24 million Americans take drugs to lower high blood pressure, at an estimated annual cost of about $15.5 billion, the article states.