Hypertension trials: 1990 to 2000.
A large number of randomized controlled trials have been published over the past decade. The earlier ones established the benefits of low-dose diuretic-based therapy. The more recent ones have documented the equal overall effectiveness of therapy based on an angiotensin-converting enzyme inhibitor or a calcium antagonist. The comparative data do not clearly define a single superior drug for most hypertensive patients, so the initial choice should be individualized, on the basis of the concomitant conditions. For the rapidly increasing population of diabetic hypertensive patients, similar conclusions are obvious, with the caveat that an angiotensin-converting enzyme inhibitor should usually be the initial choice, with diuretics and calcium antagonists usually needed to accomplish adequate control. There are no concerns about the use of calcium antagonists in diabetic patients.
Kaplan
N M
NM
Department of Internal Medicine, The University of Texas Southwestern Medical Center at Dallas, 75390-8899, USA.
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003327:Coronary Disease / Q000517:prevention & control; D048909:Diabetes Complications; D004232:Diuretics / Q000627:therapeutic use; D006333:Heart Failure / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000639:trends; D020521:Stroke / Q000517:prevention & control
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics