Table 11-4

Table 11-4. Clinical trial and guideline basis for compelling indications for individual drug classes.

	Recommended Drugs
High-Risk Conditions with Compelling Indication¹	Diuretic	β-Blocker	ACE Inhibitor	ARB	CCB	Aldosterone Antagonist	Clinical Trial Basis²
Heart failure	•	•	•	•		•	ACC/AHA Heart Failure Guideline, MERIT-HF, COPERNICUS, CIBIS, SOLVD, AIRE, TRACE, ValHEFT, RALES
Post-myocardial infarction		•	•			•	ACC/AHA Post-MI Guideline, BHAT, SAVE, Capricorn, EPHESUS
High coronary disease risk	•	•	•		•		ALLHAT, HOPE, ANBP2, LIFE, CONVINCE
Diabetes mellitus	•	•	•	•	•		NKF-ADA Guideline, UKPDS, ALLHAT
Chronic kidney disease			•	•			NKF Guideline, Captopril Trial, RENAAL, IDNT, REIN, AASK
Recurrent stroke prevention	•		•				PROGRESS

AASK = African American Study of Kidney Disease and Hypertension; ACC/AHA = American College of Cardiology/American Heart Association; ACE = angiotensin converting enzyme; AIRE = Acute Infarction Ramipril Efficacy; ALLHAT = Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial; ANBP2 = Second Australian National Blood Pressure Study; ARB = angiotensin receptor blocker; BHAT = β-Blocker Heart Attack Trial; CCB = calcium channel blocker; CIBIS = Cardiac Insufficiency Bisoprolol Study; CONVINCE = Controlled Onset Verapamil Investigation of Cardiovascular End Points; COPERNICUS = Carvedilol Prospective Randomized Cumulative Survival Study; EPHESUS = Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study; HOPE = Heart Outcomes Prevention Evaluation Study; IDNT = Irbesartan Diabetic Nephropathy Trial; LIFE = Losartan Intervention For Endpoint Reduction in Hypertension Study; MERIT-HF = Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure; NKF-ADA = National Kidney Foundation-American Diabetes Association; PROGRESS = Perindopril Protection Against Recurrent Stroke Study; RALES = Randomized Aldactone Evaluation Study: REIN = Ramipril Efficacy in Nephropathy Study; RENAAL = Reduction of Endpoints in Non-Insulin-Dependent Diabetes Mellitus with the Angiotensin II Antagonist Losartan Study; SAVE = Survival and Ventricular Enlargement Study; SOLVD = Studies of Left Ventricular Dysfunction; TRACE = Trandolapril Cardiac Evaluation Study; UKPDS = United Kingdom Prospective Diabetes Study; ValHEFT = Valsartan Heart Failure Trial.

¹Compelling indications for antihypertensive drugs are based on benefits from outcome studies or existing clinical guidelines; the compelling indication is managed in parallel with the blood pressure.

²Conditions for which clinical trials demonstrate benefit of specific classes of antihypertensive drugs.

From Chobanian AV et al: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289:2560.

Table 11-4

Table 11-4. Clinical trial and guideline basis for compelling indications for individual drug classes.

	Recommended Drugs
High-Risk Conditions with Compelling Indication¹	Diuretic	β-Blocker	ACE Inhibitor	ARB	CCB	Aldosterone Antagonist	Clinical Trial Basis²
Heart failure	•	•	•	•		•	ACC/AHA Heart Failure Guideline, MERIT-HF, COPERNICUS, CIBIS, SOLVD, AIRE, TRACE, ValHEFT, RALES
Post-myocardial infarction		•	•			•	ACC/AHA Post-MI Guideline, BHAT, SAVE, Capricorn, EPHESUS
High coronary disease risk	•	•	•		•		ALLHAT, HOPE, ANBP2, LIFE, CONVINCE
Diabetes mellitus	•	•	•	•	•		NKF-ADA Guideline, UKPDS, ALLHAT
Chronic kidney disease			•	•			NKF Guideline, Captopril Trial, RENAAL, IDNT, REIN, AASK
Recurrent stroke prevention	•		•				PROGRESS

²Conditions for which clinical trials demonstrate benefit of specific classes of antihypertensive drugs.

From Chobanian AV et al: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289:2560.