Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 study

Left ventricular mass and systolic dysfunction in essential hypertension

“…34 In humans, angiotensin-converting enzyme inhibitors were shown to be significantly more effective than calcium-channel blockers, and marginally more than diuretics and ␤-blockers, in prevention of congestive heart failure in elderly hypertensive patients. 35 There is some evidence that regression of LV hypertrophy induced by antihypertensive treatment is accompanied by an improvement in midwall systolic function, [36][37][38] even in the absence of concomitant changes in LV geometry. 37 Further studies are needed to demonstrate whether treatment-induced regression of LV hypertrophy, and the possibly associated improvement in myocardial function, [36][37][38] might lead to a more effective prevention of heart failure in essential hypertension.…”

Use of dihydropyridine calcium channel blockers in the management of hypertension in Eastern Asians: A scientific statement from the Asian Pacific Heart Association

“…LIving with Systolic Hypertension), 33 ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), 34,35 ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) 36 and VALUE (Valsartan Antihypertensive Long-term Use Evaluation) 37 trials with amlodipine, the STOP-2 (Swedish Trial in Old Patients with hypertension-2) trial with felodipine and isradipine 38 and the INSIGHT (International Nifedipine GITS Study-Intervention as a Goal for Hypertension Therapy) trial with nifedipine GITS. 39 In the amlodipine trials, [33][34][35][36][37] amlodipine reduced systolic blood pressure slightly less than chlothalidone (+1.0 mm Hg) 34 and slightly more than lisinopril in ALLHAT (À1.5 mm Hg), 35 valsartan in VALUE (À2.0 mm Hg), 37 atenolol in ASCOT (À2.8 mm Hg) 36 and hydrochlorothiazide in ACCOMPLISH (À0.9 mm Hg).…”

“…Both felodipine and isradipine reduced systolic blood pressure equivalently compared with the other medications and provided slightly superior protection against stroke (À2 and À12% (P¼0.16)), but inferior protection against myocardial infarction (+23% (P¼0.02) and +18% (P¼0.13)). 38 In the INSIGHT trial, nifedipine GITS, compared with co-amilozide (hydrochlorothiazide 25 mg/amiloride 2.5 mg), reduced systolic blood pressure similarly and provided slightly superior protection against stroke (À13%; P¼0.60), but slightly inferior protection against myocardial infarction (+20%; P¼0.19). 39 In summary, in these trials, which were predominantly conducted with Caucasian subjects, CCBs provided more protection against stroke but had divergent effects on the risk of myocardial infarction, with favorable results in the amlodipine trials.…”

“…National guidelines in the region, and possibly regional guidelines in the future, should provide clearer recommendations on the choice of antihypertensive drugs and recommend the use of CCBs as the initial therapy in patients with uncomplicated hypertension. 38 Syst-China (Systolic Hypertension in China trial); 1,2 VALUE (Valsartan Antihypertensive Long-term Use Evaluation). 37 …”

Interactions between five candidate genes and antihypertensive drug therapy on blood pressure

“…Evidence from randomized trials has shown that drug treatment reduces the risk of cardiovascular morbidity and mortality. 1,2 Despite the availability of a variety of effective drugs, inadequate control of blood pressure is still common in hypertensive patients. 3 Among the possible causes are, besides environmental, certain genetic characteristics that could have modified the response to antihypertensive drugs.…”