[Effect of antihypertensive therapy on the prevalence of ischemic cardiopathy in arterial hypertension. New contributions].
Because hypertension is a major risk factor for cardiovascular disease it would be expected that therapeutic reduction of blood pressure would protect patients from coronary heart disease (CHD). Twelve long-term trials involving over 40,000 patients have been performed to study the effectiveness of diuretics and beta-blockers in controlling blood pressure and reducing cardiovascular morbidity and mortality. However, no other drugs have been tested. The Hypertension Detection and Follow-up Program, European Working Party in the Elderly and the Metoprolol Atherosclerosis Prevention in Hypertension trial were the only studies where a significant reduction in total, cardiac and cardiovascular mortality were observed. Moreover three large trials have demonstrated some reduction in CHD among male nonsmokers. This review examines all these trials as well as some of the reasons for this disappointing outcome. New trials using modern antihypertensive drugs should be performed to analyze whether they contribute directly to protection from coronary events and other cardiovascular complications.
Instituto de Farmacología, Facultad de Medicina, Universidad Complutense, Madrid.
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Tamargo
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D012107:Research Design
D000959:Antihypertensive Agents
Efecto de la terapéutica antihipertensiva sobre la prevalencia de la cardiopatía isquémica en la hipertensión arterial. Nuevas aportaciones.