Relative benefits of different antihypertensive drugs in the prevention of vascular complications.
Large-scale clinical trials of antihypertensive drugs that have shown a reduction in morbidity and mortality used the classic step-care treatment design, initiating treatment with a diuretic. Long-term morbidity and mortality reports comparing the newer classes of agents with the traditional antihypertensive agents have not been completed. A recent meta-analysis of 13 randomized, controlled clinical trials of hypertension showed that 18 elderly people, but two to four times as many younger people, needed to be treated for 5 years to prevent one cerebrovascular or cardiac event. Any head-to-head comparisons of one class of antihypertensive agent with another in the prevention of vascular complications will require very large cohorts, even of elderly people, to show a difference. Such trials are ongoing or being planned, but their results will not be available before the next century.
Rutan
G H
GH
Memphis Veterans Affairs Medical Center, Tennessee, USA.
Cushman
W C
WC
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D012307:Risk Factors; D014652:Vascular Diseases / Q000209:etiology / Q000517:prevention & control*
D000959:Antihypertensive Agents