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 .
Effect of blood pressure control and antihypertensive drug regimen on quality of life: the African American Study of Kidney Disease and Hypertension (AASK) Pilot Study.
The African American Study of Kidney Disease and Hypertension ( AASK ) Pilot Study evaluated the feasibility of carrying out a r and omized , multicenter , 7-year clinical trial to determine the effects of two goal levels of blood pressure control and three antihypertensive drug regimens on decline in glomerular filtration rate in African Americans with clinical ly diagnosed hypertensive nephrosclerosis . Participants were r and omized to either a usual mean arterial blood pressure ( MAP ) goal group ( 102 - 107 mm Hg ) or a low-MAP goal group ( < or = 92 mm Hg ) and to a drug regimen ( initial therapy with either atenolol , amlodipine , or enalapril ) . Quality of life was assessed by the Medical Outcomes Short-Form 36 ( MOS SF-36 ) at baseline and the last follow-up visit for 84 of the 94 participants of the AASK Pilot Study . Symptoms were assessed at baseline and throughout the course of therapy by participant self-report . Mean SF-36 scores increased significantly on physical functioning ( 9.2 ) , role limitations ( physical ) ( 19.0 ) , social functioning ( 9.0 ) , and vitality dimensions ( 5.6 ) from baseline to the last follow-up visit in the usual MAP goal group . Scores for the eight health dimensions assessed by the MOS SF-36 did not change significantly during the same time period either in the low-MAP goal group or in any of the drug regimens . The mean score for general health perception was significantly lower at the last follow-up visit in the enalapril drug regimen ( 49.9 ) compared to drug regimens with atenolol ( 65.4 ) or amlodipine ( 63.9 ) . Physical functioning , role limitations ( emotional ) , social functioning , mental health , vitality , and general health perception scores were negatively correlated with self-reported symptoms during treatment . We conclude that selected dimensions of quality of life improved during the AASK Pilot Study only in participants r and omized to the usual MAP goal group . Significant differences between MAP goal groups and drug regimens at the end of follow-up were observed for only a few health dimensions
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 .