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Previous Volume 348:583-592 February 13, 2003 Number 7 Next

	Full Text PDF PDA Full Text Supplementary Material Editorial by Frohlich, E. D. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Treatment of hypertension with diuretics, beta-blockers, or both leads to improved outcomes. It has been postulated that agents that inhibit the renin–angiotensin system confer benefit beyond the reduction of blood pressure alone. We compared the outcomes in older subjects with hypertension who were treated with angiotensin-converting–enzyme (ACE) inhibitors with the outcomes in those treated with diuretic agents.

Methods We conducted a prospective, randomized, open-label study with blinded assessment of end points in 6083 subjects with hypertension who were 65 to 84 years of age and received health care at 1594 family practices. Subjects were followed for a median of 4.1 years, and the total numbers of cardiovascular events in the two treatment groups were compared with the use of multivariate proportional-hazards models.

Results At base line, the treatment groups were well matched in terms of age, sex, and blood pressure. By the end of the study, blood pressure had decreased to a similar extent in both groups (a decrease of 26/12 mm Hg). There were 695 cardiovascular events or deaths from any cause in the ACE-inhibitor group (56.1 per 1000 patient-years) and 736 cardiovascular events or deaths from any cause in the diuretic group (59.8 per 1000 patient-years; the hazard ratio for a cardiovascular event or death with ACE-inhibitor treatment was 0.89 [95 percent confidence interval, 0.79 to 1.00]; P=0.05). Among male subjects, the hazard ratio was 0.83 (95 percent confidence interval, 0.71 to 0.97; P=0.02); among female subjects, the hazard ratio was 1.00 (95 percent confidence interval, 0.83 to 1.21; P=0.98); the P value for the interaction between sex and treatment-group assignment was 0.15. The rates of nonfatal cardiovascular events and myocardial infarctions decreased with ACE-inhibitor treatment, whereas a similar number of strokes occurred in each group (although there were more fatal strokes in the ACE-inhibitor group).

Conclusions Initiation of antihypertensive treatment involving ACE inhibitors in older subjects, particularly men, appears to lead to better outcomes than treatment with diuretic agents, despite similar reductions of blood pressure.

Source Information

From the School of Medicine, Flinders University, Adelaide (L.M.H.W.); the Baker Heart Research Institute, Melbourne (C.M.R., G.L.R.J., C.I.J.); the Department of Public Health, University of Adelaide, Adelaide (P.R.); the Department of Medicine, University of Western Australia, Perth (L.J.B.); the Department of Nephrology, University of New South Wales, Sydney (M.A.B.); the Department of Epidemiology and Preventive Medicine, Monash University, Melbourne (J.J.M.); Merck Sharp & Dohme, Sydney (G.J.M.); the Faculty of Health, University of Newcastle, Newcastle (J.E.M.); the Department of Physiology, University of Melbourne, Melbourne (T.O.M.); and the Department of Medicine, University of Queensland, Brisbane (M.J.W.) — all in Australia.

Address reprint requests to Dr. Reid at the Baker Heart Research Institute, P.O. Box 6492, St. Kilda Rd. Central, Melbourne, VIC 8008, Australia, or at chris.reid{at}baker.edu.au.

Full Text of this Article

Related Letters:

Angiotensin-Converting–Enzyme Inhibitors and Diuretics for Hypertension
Pickering T. G., Krut L. H., Reese A. M., Talbert R. L., Bussey H. I., Esnault V. L.M., Davis B. R., Wright J. T. Jr., Cutler J. A., Wing L. M.H., Reid C. M., Jennings G. L.R., the ANBP2 Management Committee , Frohlich E. D.
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N Engl J Med 2003; 349:90-93, Jul 3, 2003. Correspondence

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• Pinto, E. (2007). Blood pressure and ageing. Postgrad. Med. J. 83: 109-114 [Abstract] [Full Text]  
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• Strauss, M. H., Hall, A. S. (2006). Angiotensin Receptor Blockers May Increase Risk of Myocardial Infarction: Unraveling the ARB-MI Paradox. Circulation 114: 838-854 [Full Text]  
• Kotchen, T. A. (2006). From Clinical Trials to Clinical Practice: Why the Gap?. Hypertension 48: 196-197 [Full Text]  
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• Psaty, B. M., Weiss, N. S., Furberg, C. D. (2006). Recent Trials in Hypertension: Compelling Science or Commercial Speech?. JAMA 295: 1704-1706 [Full Text]  
• Salvetti, A., Ghiadoni, L. (2006). Thiazide Diuretics in the Treatment of Hypertension: An Update. J. Am. Soc. Nephrol. 17: S25-S29 [Abstract] [Full Text]  
• Volpe, M., Tocci, G., Pagannone, E. (2006). Fewer Mega-Trials and More Clinically Oriented Studies in Hypertension Research? The Case of Blocking the Renin-Angiotensin-Aldosterone System.. J. Am. Soc. Nephrol. 17: S36-S43 [Abstract] [Full Text]  
• Dart, A. M., Gatzka, C. D., Kingwell, B. A., Willson, K., Cameron, J. D., Liang, Y.-L., Berry, K. L., Wing, L. M.H., Reid, C. M., Ryan, P., Beilin, L. J., Jennings, G. L.R., Johnston, C. I., McNeil, J. J., MacDonald, G. J., Morgan, T. O., West, M. J. (2006). Brachial Blood Pressure But Not Carotid Arterial Waveforms Predict Cardiovascular Events in Elderly Female Hypertensives. Hypertension 47: 785-790 [Abstract] [Full Text]  
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• Jochmann, N., Stangl, K., Garbe, E., Baumann, G., Stangl, V. (2005). Female-specific aspects in the pharmacotherapy of chronic cardiovascular diseases. Eur Heart J 26: 1585-1595 [Abstract] [Full Text]  
• Verdecchia, P., Reboldi, G., Angeli, F., Gattobigio, R., Bentivoglio, M., Thijs, L., Staessen, J. A., Porcellati, C. (2005). Angiotensin-Converting Enzyme Inhibitors and Calcium Channel Blockers for Coronary Heart Disease and Stroke Prevention. Hypertension 46: 386-392 [Abstract] [Full Text]  
• Verma, S., Leiter, L. A., Lonn, E. M., Strauss, M. H. (2005). Perindopril in diabetes: perspective from the EUROPA substudy, PERSUADE. Eur Heart J 26: 1347-1349 [Full Text]  
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• Williams, B. (2005). Recent hypertension trials: Implications and controversies. J Am Coll Cardiol 45: 813-827 [Abstract] [Full Text]  
• Blankfield, R. P. (2005). Fluid Matters in Choosing Antihypertensive Therapy: A Hypothesis That the Data Speak Volumes. J Am Board Fam Med 18: 113-124 [Abstract] [Full Text]  
• Mancia, G., Grassi, G. (2005). Joint National Committee VII and European Society of Hypertension/European Society of Cardiology Guidelines for Evaluating and Treating Hypertension: A Two-Way Road?. J. Am. Soc. Nephrol. 16: S74-S77 [Abstract] [Full Text]  
• Kizer, J. R., Dahlof, B., Kjeldsen, S. E., Julius, S., Beevers, G., de Faire, U., Fyhrquist, F., Ibsen, H., Kristianson, K., Lederballe-Pedersen, O., Lindholm, L. H., Nieminen, M. S., Omvik, P., Oparil, S., Wedel, H., Wachtell, K., Edelman, J. M., Snapinn, S. M., Harris, K. E., Devereux, R. B. (2005). Stroke Reduction in Hypertensive Adults With Cardiac Hypertrophy Randomized to Losartan Versus Atenolol: The Losartan Intervention For Endpoint Reduction in Hypertension Study. Hypertension 45: 46-52 [Abstract] [Full Text]  
• Zanchetti, A., Crepaldi, G., Bond, M. G., Gallus, G., Veglia, F., Mancia, G., Ventura, A., Baggio, G., Sampieri, L., Rubba, P., Sperti, G., Magni, A., on behalf of PHYLLIS Investigators, (2004). Different Effects of Antihypertensive Regimens Based on Fosinopril or Hydrochlorothiazide With or Without Lipid Lowering by Pravastatin on Progression of Asymptomatic Carotid Atherosclerosis: Principal Results of PHYLLIS--A Randomized Double-Blind Trial. Stroke 35: 2807-2812 [Abstract] [Full Text]  
• Elliott, W. J. (2004). Management of Hypertension in the Very Elderly Patient. Hypertension 44: 800-804 [Abstract] [Full Text]  
• Montori, V. M, Jaeschke, R., Schunemann, H. J, Bhandari, M., Brozek, J. L, Devereaux, P J, Guyatt, G. H (2004). Users' guide to detecting misleading claims in clinical research reports. BMJ 329: 1093-1096 [Full Text]  
• Psaty, B. M., Lumley, T., Furberg, C. D. (2004). Chlorthalidone vs Other Low-Dose Diuretics--Reply. JAMA 292: 1817-1817 [Full Text]  
• Choi, K. L., Chua, D., Elliott, W. J. (2004). Chlorthalidone vs Other Low-Dose Diuretics. JAMA 292: 1816-1817 [Full Text]  
• Zanobetti, A., Canner, M. J., Stone, P. H., Schwartz, J., Sher, D., Eagan-Bengston, E., Gates, K. A., Hartley, L. H., Suh, H., Gold, D. R. (2004). Ambient Pollution and Blood Pressure in Cardiac Rehabilitation Patients. Circulation 110: 2184-2189 [Abstract] [Full Text]  
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• Schiffrin, E. L., Touyz, R. M. (2004). From bedside to bench to bedside: role of renin-angiotensin-aldosterone system in remodeling of resistance arteries in hypertension. Am. J. Physiol. Heart Circ. Physiol. 287: H435-H446 [Full Text]  
• Zhou, M.-S., Jaimes, E. A., Raij, L. (2004). Atorvastatin Prevents End-Organ Injury in Salt-Sensitive Hypertension: Role of eNOS and Oxidant Stress. Hypertension 44: 186-190 [Abstract] [Full Text]  
• Pedelty, L., Gorelick, P. B. (2004). Chronic Management of Blood Pressure After Stroke. Hypertension 44: 1-5 [Full Text]  
• Franco, V., Oparil, S., Carretero, O. A. (2004). Hypertensive Therapy: Part II. Circulation 109: 3081-3088 [Full Text]  
• Morgan, T., Anderson, A., Bertram, D., MacInnis, R. J. (2004). Effect of candesartan and lisinopril alone and in combination on blood pressure and microalbuminuria. Journal of Renin-Angiotensin-Aldosterone System 5: 64-71 [Abstract]  
• Field, K. M., Pepin, J. L., Mehta, M. D. (2004). Knowing When to Play the Ace: The Use and Under Use of Ace Inhibitors in Primary Practice. Journal of Pharmacy Practice 17: 197-210 [Abstract]  
• Dart, A. M., Gatzka, C. D., Cameron, J. D., Kingwell, B. A., Liang, Y.-L., Berry, K. L., Reid, C. M., Jennings, G. L. (2004). Large Artery Stiffness Is Not Related to Plasma Cholesterol in Older Subjects with Hypertension. Arterioscler. Thromb. Vasc. Bio. 24: 962-968 [Abstract] [Full Text]  
• Benson, S. C., Pershadsingh, H. A., Ho, C. I., Chittiboyina, A., Desai, P., Pravenec, M., Qi, N., Wang, J., Avery, M. A., Kurtz, T. W. (2004). Identification of Telmisartan as a Unique Angiotensin II Receptor Antagonist With Selective PPAR{gamma}-Modulating Activity. Hypertension 43: 993-1002 [Abstract] [Full Text]  
• Verdecchia, P., Reboldi, G., Angeli, F., Borgioni, C., Gattobigio, R., Filippucci, L., Norgiolini, S., Bracco, C., Porcellati, C. (2004). Adverse Prognostic Significance of New Diabetes in Treated Hypertensive Subjects. Hypertension 43: 963-969 [Abstract] [Full Text]  
• Fournier, A., Messerli, F. H., Achard, J. M., Fernandez, L. (2004). Cerebroprotection mediated by angiotensin II: A hypothesis supported by recent randomized clinical trials. J Am Coll Cardiol 43: 1343-1347 [Abstract] [Full Text]  
• Fischer, M. A., Avorn, J. (2004). Economic Implications of Evidence-Based Prescribing for Hypertension: Can Better Care Cost Less?. JAMA 291: 1850-1856 [Abstract] [Full Text]  
• Sheldon, J. (2004). Clinical hypertension in practice. Gregory YH Lip. (110 pages, {pound}14.95.) Royal Society of Medicine Press Ltd, 2003. ISBN 1-85315-485-7. Fam Pract 21: 225-225 [Full Text]  
• Lawes, C. M.M., Bennett, D. A., Feigin, V. L., Rodgers, A. (2004). Blood Pressure and Stroke: An Overview of Published Reviews. Stroke 35: 1024-1033 [Abstract] [Full Text]  
• O'Rourke, F., Dean, N., Akhtar, N., Shuaib, A. (2004). Current and future concepts in stroke prevention. CMAJ 170: 1123-1133 [Abstract] [Full Text]  
• Cipollone, F., Fazia, M., Iezzi, A., Pini, B., Cuccurullo, C., Zucchelli, M., de Cesare, D., Ucchino, S., Spigonardo, F., De Luca, M., Muraro, R., Bei, R., Bucci, M., Cuccurullo, F., Mezzetti, A. (2004). Blockade of the Angiotensin II Type 1 Receptor Stabilizes Atherosclerotic Plaques in Humans by Inhibiting Prostaglandin E2-Dependent Matrix Metalloproteinase Activity. Circulation 109: 1482-1488 [Abstract] [Full Text]