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 single-drug therapy on reduction of left ventricular mass in mild to moderate hypertension: comparison of six antihypertensive agents. The Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents.
BACKGROUND Antihypertensive drugs may differ in their ability to reduce LV mass . Covariates other than drug selection , such as pretreatment LV mass , body weight , the magnitude of blood pressure reduction , race , and age may modify the response of LV mass to therapy . METHODS AND RESULTS Patients with mild to moderate hypertension ( diastolic blood pressure , 95 to 109 mm Hg ) were r and omly allocated to treatment with atenolol , captopril , clonidine , diltiazem , hydrochlorothiazide , or prazosin in a double-masked trial . Patients achieving the goal diastolic blood pressure of < 90 mm Hg during drug titration entered a 1-year maintenance period . Longitudinal analysis examined changes from baseline echocardiogram in LV mass at 8 weeks and at 1 year , statistically adjusted for pretreatment LV mass , systolic blood pressure , body weight , sodium excretion , physical activity , race , and age . Significant reductions at 1 year in adjusted LV mass were seen for patients in the highest tertile of pretreatment LV mass treated with hydrochlorothiazide ( mean , -42.9 ; 95 % confidence limits , -65.5 , -20.2 g ) , captopril ( mean , -38.7 ; 95 % confidence limits , -61.0 , -16.4 g ) , and atenolol ( mean , -28.1 ; 95 % confidence limits , -50.9 , -5.3 g ) . These treatment effects differed from those of prazosin , diltiazem , or clonidine . CONCLUSIONS Antihypertensive drugs have disparate effects on LV mass independent of the magnitude of blood pressure reduction . Patients with adequate blood pressure control on captopril , hydrochlorothiazide , and atenolol show a reduction of LV mass after 1 year of treatment , whereas patients on diltiazem , clonidine , or prazosin do not
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 .