Diuretics best BP therapy for blacks

New data fail to support the idea that newer drugs have advantages over diuretic "water pills" for people with high blood pressure (BP), whether or not they have the "metabolic syndrome" - a cluster of conditions that include obesity, high triglycerides, and insulin resistance as well as hypertension.

The findings come from a large trial called ALLHAT, which compared different types of blood pressure treatments.

"The findings are especially true in African-American hypertensives," said ALLHAT researcher Dr. Jackson T. Wright, from Case Western Reserve University School of Medicine in Cleveland. He presented the data this past weekend at the International Society on Hypertension in Blacks in San Juan, Puerto Rico.

The ALLHAT group analyzed rates of cardiovascular and kidney complications among more than 18,100 hypertensive patients with the metabolic syndrome, of whom 5,763 were African American, and 11,180 without the metabolic syndrome, of whom 4,277 were African American.

Metabolic syndrome Overview

Sometimes, the whole really is greater than the sum of its parts. Such is the case with metabolic syndrome.

Metabolic syndrome isn't a disease, but is a cluster of disorders of your body's metabolism - including high blood pressure, high insulin levels, excess body weight and abnormal cholesterol levels - that make you more likely to develop Diabetes, Heart disease or Stroke. Each of these disorders is by itself a risk factor for other diseases. In combination, though, these disorders dramatically boost your chances of developing potentially life-threatening illnesses.

Doctors have talked about this constellation of risk factors for years, and have called it many names, including syndrome X, the deadly quartet and insulin resistance syndrome. But several studies support what doctors have suspected all along - this syndrome is common and it's becoming more prevalent. As many as one in four American adults and 40 percent of adults age 40 or older have metabolic syndrome, an increase of 61 percent over the last decade.

Partly because of these increasing numbers, doctors have defined the syndrome more clearly and developed guidelines for diagnosing it. Now, this powerful predictor of disease is a valuable preventive tool. If you have metabolic syndrome, you have the opportunity to make aggressive lifestyle changes today that can delay or derail the development of serious diseases.

As part of ALLHAT, these individuals were randomly assigned to a diuretic (chlorthalidone), a calcium channel blocker (amlodipine) or an ACE inhibitor (lisinopril).