Diuretics prevent more cardiovascular complications than other monotherapies
Diuretics are more effective than other monotherapies in preventing cardiovascular disease complications, an analysis of different treatments has shown.
Data from the US Women’s Health Initiative observational study
showed that use of calcium channel blocker monotherapy was associated
with a greater risk of cardiovascular death than for diuretic monotherapy
(hazard ratio, 1.55, 95 per cent confidence interval 1.02–2.35).
The study also revealed that a regimen of calcium channel blocker plus
diuretic was associated with a higher risk of cardiovascular mortality
than a regimen based on a beta-blocker plus diuretic. Risks were similar
for angiotensin-converting enzyme inhibitors plus diuretics and beta-blockers
plus diuretics.
The study involved over 90,000 participants, over 30,000 of whom had
hypertension with no history of cardiovascular disease (JAMA 2004;292:2849).
Global burden The number of adults with hypertension is predicted
to rise by about 60 per cent by 2025 bringing the total number to
1.56 billion worldwide. Researchers pooled information about the
prevalence of hypertension and estimate that in 2000 26.4 per cent
of the adult population had hypertension. By 2025, 29.2 per cent
of the population are projected to suffer from this condition (Lancet 2005;365:217).
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