Dr. Paul Whelton of the Chicago-area Loyola University Health System points out diuretics, which cost $25 to $40 per year, can be better than the newer brand-name blood pressure drugs that can cost up to $300 to $600 yearly.
Whelton chaired the drug trial that randomly assigned more than 33,000 patients with high-blood pressure to take either a diuretic, chlorthalidone, a calcium channel blocker, amlodipine, or an ACE inhibitor, lisinopril.
In 2002, the researchers found among patients followed for four to eight years, the diuretic was better than the calcium channel blocker in preventing heart failure and better than the ACE inhibitor in preventing stroke, heart failure and overall cardiovascular disease.
After the patients were followed an additional four to five years, Whelton says, the differences among the three drugs narrowed -- by most measures they were a statistical dead heat, but the diuretic still was superior in two measures.
Compared with the diuretic group, the ACE inhibitor group had a 20 percent higher death rate from stroke, and the calcium channel blocker group had a 12 percent higher rate of hospitalizations and deaths due to heart failure.
Whelton presented the results at the plenary session of the China Heart Congress and International Heart Forum held in Beijing.
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