Diuretics are preferred first-line over CCBs to optimize reduction of cardiovascular events .
The review does not distinguish between CCBs , ACE inhibitors or ARBs , but does provide evidence supporting the use of CCBs over beta-blockers .
BACKGROUND Calcium channel blockers ( CCBs ) are a relatively new antihypertensive class .
The effect of first-line CCBs on the prevention of cardiovascular events , as compared with other antihypertensive drug classes , is unknown .
OBJECTIVES To determine whether CCBs used as first-line therapy for hypertension are different from other first-line drug classes in reducing the incidence of major adverse cardiovascular events .
Characteristics of participants at baseline in the Treatment of Mild Hypertension Study (TOMHS).
The Treatment of Mild Hypertension Study ( TOMHS ) is a r and omized , double-blind clinical trial currently being conducted to compare the effects of nonpharmacologic therapy alone with those of 1 of 5 active drug regimens combined with nonpharmacologic therapy , for long-term management of patients with mild hypertension . Six classes of drugs were studied : ( 1 ) acebutolol ( beta blocker ) , ( 2 ) amlodipine ( calcium antagonist ) , ( 3 ) chlorthalidone ( diuretic ) , ( 4 ) doxazosin ( alpha 1 antagonist ) , ( 5 ) enalapril ( angiotensin-converting enzyme inhibitor ) and ( 6 ) placebo . All participants received nutritional-hygienic advice to reduce weight and sodium and alcohol intakes and to increase physical activity . End points include blood pressure change , side effects and quality -of-life indices ; incidence of electrocardiographic and echocardiographic abnormalities ; and incidence of cardiovascular clinical events , including death , among participants receiving drugs as first-step treatment as well as nonpharmacologic treatment compared with incidence among those participants r and omized to nonpharmacologic treatment only as the initial step
Diuretics are preferred first-line over CCBs to optimize reduction of cardiovascular events .
The review does not distinguish between CCBs , ACE inhibitors or ARBs , but does provide evidence supporting the use of CCBs over beta-blockers .
BACKGROUND Calcium channel blockers ( CCBs ) are a relatively new antihypertensive class .
The effect of first-line CCBs on the prevention of cardiovascular events , as compared with other antihypertensive drug classes , is unknown .
OBJECTIVES To determine whether CCBs used as first-line therapy for hypertension are different from other first-line drug classes in reducing the incidence of major adverse cardiovascular events .