The largest study of High Blood Pressure treatment ever conducted in Europe found newer anti-hypertensive drugs worked better than older ones and had a dramatic impact on patients’ health, especially when given with a cholesterol-lowering agent.
The 19,000-person trial was halted last November because the drugs proved so much better than conventional treatment, but final details have only now been presented to clinicians and published in the Lancet medical journal.
The 5-year trial compared the older drug regime of a beta blocker and a diuretic with a combination of two newer blood pressure medicines - Pfizer Inc.‘s Norvasc and Aceon/Coversyl from CV Therapeutics Inc. and Solvay SA.
Norvasc, known generically as amlodipine, is a calcium channel blocker, while Aceon/Coversyl, or perindopril, is an ACE inhibitor, originally developed by France’s Servier.
In addition, 10,000 patients were also treated with Pfizer’s cholesterol-lowering drug Lipitor.
The researchers found the newer blood-pressure drugs reduced the risk of Strokes by about 25 percent, Heart Attacks by 15 percent, cardiovascular deaths by 25 percent and new cases of diabetes by 30 percent compared with standard treatment.
Adding Lipitor, or atorvastatin, cut the remaining risk still further, even when patients did not have especially high cholesterol levels.
Pfizer was the trial’s principal sponsor.
Professor Peter Sever of Imperial College in London, co-chairman of the study, said the data would cause doctors to re-evaluate guidelines for using beta blockers as first-line treatment and highlighted the need for holistic treatment.
“If you could translate that to the millions people with hypertension that would result in a colossal saving of life.”
In the past, there had been a tendency for doctors to take a “silo” approach to treating different risk factors, he said, but avoiding Strokes and hearts attacks was all about tackling interacting risk factors.
The latest findings will re-ignite debate about treating High Blood Pressure and may mean international recommendations for managing the condition need to be reviewed.
Beta blockers, which are mostly off patent and sold generically, have been standard therapy for High Blood Pressure, chest pain and heart failure for years.
In a separate editorial commentary on the study in the Lancet, Jan Staessen of the University of Leuven, Belgium, said the study showed the value to society of treating blood pressure effectively to head off the danger of heart attacks and stroke.
“Governments and health care insurers will have to accept that the use of anti-hypertensive drugs cannot be rationed,” he wrote.
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Revision date: June 22, 2011
Last revised: by Jorge P. Ribeiro, MD