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 .
Design and baseline characteristics of participants in the African American Study of Kidney Disease and Hypertension (AASK) Pilot Study.
Hypertension and end-stage renal disease ( ESRD ) are major causes of morbidity and mortality in the United States , especially among African Americans . The African American Study of Kidney Disease and Hypertension ( AASK ) Pilot Study evaluated the feasibility of conducting a long-term clinical trial to compare the effects of two levels of blood pressure control and three different antihypertensive drug regimens on the rate of decline in glomerular filtration rate ( GFR ) in African Americans with clinical ly diagnosed hypertensive renal disease . African American men and women aged 18 - 70 years with a GFR of 25 - 70 ml/min/ 1.73m2 and hypertension were r and omized in a 3 x 2 factorial design to initial treatment with either an angiotensin-converting enzyme inhibitor ( enalapril ) , a calcium channel blocker ( amlodipine ) , or a beta blocker ( atenolol ) and to a mean arterial blood pressure ( goal MAP ) of either 102 - 107 mm Hg or < or = 92 mm Hg . Furosemide , doxazosin , clonidine , hydralazine , and minoxidil were added sequentially until goal MAP was achieved . To compare the pathologic diagnosis with the clinical diagnosis of renal disease , study participants without contraindication were also asked to undergo a renal biopsy . The goals of the AASK Pilot Study were to evaluate recruitment techniques , adherence to prescribed antihypertensive drug regimens , ability of the antihypertensive regimens to achieve blood pressure goals , rates of participation in scheduled clinic visits and procedures , and variability of GFR measurements . A further goal was to obtain renal biopsy data in at least 75 % of the r and omized study participants . Compared to the ESRD patient population whose renal disease is caused by hypertension , women were underrepresented in the AASK Pilot Study . AASK Pilot Study participants had higher  unemployment rates and lower income levels than African Americans in the general U.S. population
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 .