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 .
The Swedish Trial in old patients with hypertension-2 (STOP-hypertension-2): a progress report.
OBJECTIVE The Swedish Trial in Old Patients with Hypertension-2 ( STOP-Hypertension-2 ) was design ed by a project group of the Swedish Hypertension Society to test whether the " newer " treatment alternatives ( ACE inhibitors and calcium antagonists ) are as good as , better or less good than , the " older " ones ( beta-blockers and diuretics ) in terms of preventing cardiovascular morbidity and mortality  in elderly hypertensives . The aim of the present paper is to report on the progress of the study . DESIGN Prospect i ve , open trial with blinded end-point committee and central ized r and omization ( PROBE design ) . STOP-Hypertension-2 may be regarded as a scientific follow-up of the previously published Swedish Trial in Old Patients with Hypertension ( STOP-Hypertensioon-1 ) ( 6 ) using the same study organization . SUBJECTS By the end of 1994 when recruitment was stopped , 6628 hypertensive men ( 34 % ) and women ( 66 % ) aged 70 - 84 ( mean age 76 ) had been included at 312 Swedish health centres ( out of approximately 850 ) . In the whole cohort 11 % are diabetics and 9 % smokers . The mean total cholesterol value is 6.5 mmol/L. RESULTS In the whole study cohort , blood pressure was lowered from 194/98 mmHg to 167/85 mmHg after one year . At the end of 1995 , 319 fatal events ( all-cause mortality ) had been reported , corresponding to a mortality rate of 21.3 per 1000 person-years . CONCLUSION In STOP-Hypertension-2 , 6628 elderly hypertensive have been r and omized to three different treatment regimes : beta-blocker+diuretics ( the active treatment arm in STOP-Hypertension-1 ) , ACE inhibitors , or calcium antagonists . Their average lowering of blood pressure was 27/13 mmHg and end-points have occurred at the expected rate . Thus , it should be possible to terminate STOP-Hypertension-2 within two to three years
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 .