WHICH HEART DRUG?: Diuretics win the day

You’ve just been diagnosed with a heart problem, or perhaps high blood pressure has been detected.

Almost without thinking, your doctor reaches for his pad to write out a prescription for an ACE inhibitor, the current drug of choice.

But you, a WDDTY E-news reader, stop him. ‘Stay your hand, doctor, the ALLHAT trial says that diuretics are by far and away the best heart drugs around,’ you say.

And you’d be right. They were tested against ACE inhibitors and calcium-channel blockers in a trial involving over 33,000 people with hypertension and one other risk factor for coronary disease.

They either took the diuretic chloralidone, the ACE inhibitor lisinopril or the calcium-blocker amlodipine. The diuretic was 25 per cent more successful in stopping heart failure, and blood pressure was lower after five years in the diuretic group.

But let’s not forget, folks, it’s still a drug, and it was as bad as the rest when it came to adverse reactions, such as gastrointestinal bleeding.

(Source: Jouurnal of the American Medical Association, 2002; 288: 2981-97).

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Written by What Doctors Don't Tell You

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