Old antihypertensive agents-diuretics and β-blockers: Do we know how and in whom they lower blood pressure?

被引:2
作者
Sica D.A. [1 ]
机构
[1] MCV Station, Medical College of Virginia of Virginia Commonwealth University, Richmond, VA 23298-0160
关键词
Atenolol; Plasma Renin Activity; Essential Tremor; HCTZ; Thiazide Diuretic;
D O I
10.1007/s11906-999-0037-2
中图分类号
学科分类号
摘要
Morbidity and mortality data that increasingly favor the use of diuretics and β-blockers continue to accumulate. Nonetheless, the use of these agentsóparticularly diureticsóis viewed as a dated practice. The issue of which antihypertensive drug to use will remain complex and confusing as the marketing juggernauts of the pharmaceutical industry vigorously promote drug classes such as angiotensinconverting enzyme inhibitors, angiotensin-receptor antagonists, and calcium-channel blockers. A pharmacologic middle ground will probably be reached in the form of fixed-dose combination therapy. Diuretics and b-blockers are mechanistically rational when combined with numerous other drugs; thus, the issue of which drug should be used to begin treatment will be settled by a truce, albeit an uneasy one, favoring the increased use of fixed-dose combination antihypertensive therapy. Copyright © 1999 by Current Science Inc.
引用
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页码:296 / 304
页数:8
相关论文
共 57 条
[1]  
Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure: A cooperative study, JAMA, 237, pp. 255-261, (1977)
[2]  
The 1980 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, Arch Intern Med, 140, pp. 1280-1285, (1980)
[3]  
The 1984 report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, Arch Intern Med, 144, pp. 1045-1057, (1984)
[4]  
The fourth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, Arch Intern Med, 148, pp. 1023-1038, (1988)
[5]  
The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, Arch Intern Med, 153, pp. 154-183, (1993)
[6]  
The sixth report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure, Ann Intern Med, 157, pp. 2413-2446, (1997)
[7]  
Philipp T., Anlauf M., Distler A., Et al., Randomised, doubleblind, multicentre comparison of hydrochlorothiazide, atenolol, nitrendipine, and enalapril in hypertensive treatment: Results of the HANE study: HANE Trial Research Group, BMJ, 315, pp. 154-159, (1997)
[8]  
Hansson L., Lindholm L.H., Niskanen L., Et al., Effect of angiotensin converting enzyme inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: The Captopril Prevention Projec (CAPP) randomised trial, Lancet, 353, pp. 611-616, (1999)
[9]  
Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: Final results of the Systolic Hypertension in the Elderly Program (SHEP), JAMA, 265, pp. 3255-3264, (1991)
[10]  
Pahor M., Shorr R.I., Somes G.W., Et al., Diuretic-based treatment and cardiovascular events in patients with mild renal dysfunction enrolled in the Systolic Hypertension in the Elderly Program, Arch Intern Med, 158, pp. 1340-1345, (1998)