First-line low-dose thiazides reduce all morbidity and mortality outcomes .
First-line ACE inhibitors and calcium channel blockers may be similarly effective but the evidence is less robust .
First-line high-dose thiazides and first-line beta-blockers are inferior to first-line low-dose thiazides
BACKGROUND Sustained elevated blood pressure , unresponsive to lifestyle measures , leads to a critically important clinical question : What class of drug to use first-line ?
This review answers that question .
OBJECTIVES PRIMARY OBJECTIVE To quantify the benefits and harms of the major first-line anti-hypertensive drug classes : thiazides , beta-blockers , calcium channel blockers , angiotensin converting enzyme ( ACE ) inhibitors , alpha-blockers , and angiotensin II receptor blockers ( ARB ) .
The effect of antihypertensive treatment on electrocardiogram voltages in the EWPHE trial.
Long-term effects of antihypertensive treatment on various electrocardiogram ( ECG ) voltages and the association between ECG findings at r and omization and subsequent mortality were evaluated in the double-blind , placebo-controlled trial of elderly hypertensive patients , conducted by the European Working Party on High Blood Pressure in the Elderly ( EWPHE ) . Patients were treated with a combination of hydrochlorothiazide and triamterene or matching placebo ; methyldopa or placebo was added if blood pressures remained high . RaVL and SV1 + RV5 at r and omization were related to systolic blood pressure ( SBP ) and RaVL was also related to diastolic blood pressure ( DBP ) , after adjustment for age , gender , and body mass index ( BMI ) . When adjusted for age and body mass index , the decreases in RaVL and SV1 + RV5 were not correlated with the changes in SBP after 1 year of active treatment but the decreases in SV1 + RV5 were positively related to the fall in DBP . After 4 years of active treatment , the fall in SBP was associated with decreases in RaVL and in SV1 + RV5 , after adjustment for age and changes in BMI
First-line low-dose thiazides reduce all morbidity and mortality outcomes .
First-line ACE inhibitors and calcium channel blockers may be similarly effective but the evidence is less robust .
First-line high-dose thiazides and first-line beta-blockers are inferior to first-line low-dose thiazides
BACKGROUND Sustained elevated blood pressure , unresponsive to lifestyle measures , leads to a critically important clinical question : What class of drug to use first-line ?
This review answers that question .
OBJECTIVES PRIMARY OBJECTIVE To quantify the benefits and harms of the major first-line anti-hypertensive drug classes : thiazides , beta-blockers , calcium channel blockers , angiotensin converting enzyme ( ACE ) inhibitors , alpha-blockers , and angiotensin II receptor blockers ( ARB ) .