[The most recent study into blood pressure lowering by amlodipine: the beginning of the end for the beta-blockers].
In the 'Anglo-Scandinavian cardiac outcomes trial-blood pressure lowering arm' (ASCOT-BPLA), a regimen ofamlodipine and perindopril was compared with a classic regimen of atenolol and bendroflumethiazide in over 19,000 hypertensive subjects. Most likely related to a lower systolic blood pressure, a better metabolic profile and inferiority of the comparator atenolol, the trial showed better outcomes for total and cardiovascular mortality, fatal and nonfatal stroke and cardiovascular events and procedures for the combination of newer agents. Additionally, the newer combination was associated with a 30% reduction in new-onset diabetes mellitus. It is expected that these newer drugs will quickly replace the beta-blockers as the medication for patients with high blood pressure.
van den Meiracker
A H
AH
Academisch Medisch Centrum/Universiteit van Amsterdam, afd. Interne Geneeskunde, Amsterdam. a.vandenmeiracker@erasmusmc.nl
van Montfrans
G A
GA