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 .
Effects of Once-Daily Angiotensin-Converting Enzyme Inhibition and Calcium Channel Blockade-Based Antihypertensive Treatment Regimens on Left Ventricular Hypertrophy and Diastolic Filling in Hypertension: The Prospective Randomized Enalapril Study Evaluating Regression of Ventricular Enlargement (PR
Background —The Prospect i ve R and omized Enalapril Study Evaluating Regression of Ventricular Enlargement ( PRESERVE ) study was design ed to test whether enalapril achieves greater left ventricular ( LV ) mass reduction than does a nifedipine gastrointestinal treatment system by a prognostically meaningful degree on a population basis ( 10 g/m2 ) . Methods and Results —An ethnically diverse population of 303 men and women with essential hypertension and increased LV mass at screening echocardiography were enrolled at clinical centers on 4 continents and studied by echocardiography at baseline and after 6- and 12-month r and omized therapy . Clinical examination and blinded echocardiogram readings 48 weeks after study entry in an intention-to-treat analysis of 113 enalapril-treated and 122 nifedipine-treated patients revealed similar reductions in systolic/diastolic pressure ( −22/12 versus −21/13 mm Hg ) and LV mass index ( −15 versus −17g/m2 , both P > 0.20 ) . No significant between-treatment difference was detected in population subsets defined by monotherapy treatment , sex , age , race , or severity of baseline hypertrophy . Similarly , there was no between-treatment difference in change in velocities of early diastolic or atrial phase transmitral blood flow . More enalapril-treated than nifedipine-treated patients required supplemental treatment with hydrochlorothiazide ( 59 % versus 34 % , P < 0.001 ) but not atenolol ( 27 % versus 22 % , NS ) . Conclusions —Once-daily antihypertensive treatment with enalapril or long-acting nifedipine , plus adjunctive hydrochlorothiazide and atenolol when needed to control blood pressure , both had moderately beneficial and statistically indistinguishable effects on regression of LV hypertrophy
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 .