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Differences between blood-pressure-lowering drugs

Two papers published in this issue of The Lancet add to the existing evidence about the comparative effects of commonly used antihypertensive regimens. The INSIGHT and NORDIL trials each compared outcomes among patients assigned treatment with regimens based on calcium antagonists (nifedipine GITS a... Full description

Journal Title: The Lancet (British edition) 2000, Vol.356 (9227), p.352-353
Main Author: MacMahon, Stephen
Other Authors: Neal, Bruce
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: England: Elsevier Ltd
ID: ISSN: 0140-6736
Link: https://www.ncbi.nlm.nih.gov/pubmed/10972362
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title: Differences between blood-pressure-lowering drugs
format: Article
creator:
  • MacMahon, Stephen
  • Neal, Bruce
subjects:
  • Abridged Index Medicus
  • Adrenergic beta-Antagonists - therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors - therapeutic use
  • Antihypertensive Agents - pharmacology
  • Antihypertensive Agents - therapeutic use
  • Antihypertensive drugs
  • Blood pressure
  • Calcium Channel Blockers - therapeutic use
  • Cardiovascular disease
  • Cardiovascular Diseases - prevention & control
  • Coronary heart disease
  • Diuretics - therapeutic use
  • Heart failure
  • Humans
  • Hypertension
  • Hypertension - complications
  • Hypertension - drug therapy
  • Physiological aspects
  • Prescription drugs
  • Risk Factors
  • Stroke (Disease)
ispartof: The Lancet (British edition), 2000, Vol.356 (9227), p.352-353
description: Two papers published in this issue of The Lancet add to the existing evidence about the comparative effects of commonly used antihypertensive regimens. The INSIGHT and NORDIL trials each compared outcomes among patients assigned treatment with regimens based on calcium antagonists (nifedipine GITS and diltiazem, respectively) with outcomes among patients assigned a diuretic-based or beta-blocker-based regimen. Neither study found clear evidence of any difference in the frequencies of the pre-specified primary outcomes (combinations of major cardiovascular events), although both studies observed some differences in cause-specific outcomes. In NORDIL, there was a marginally significant lower risk of stroke with diltiazembased therapy (despite a lesser reduction in blood pressure), but there was no clear evidence of a difference in stroke risk in INSIGHT. Conversely, in INSIGHT, there was a marginally significant excess of heart failure with nifedipine-based treatment, but in NORDIL there was no clear evidence of a difference in heart-failure risk. Furthermore, although fatal myocardial infarctions were commoner with nifedipine-based treatment than with diuretic-based treatment in INSIGHT, in neither study was there a clear difference in total number of major CHD events, although the confidence intervals were wide.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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descriptionTwo papers published in this issue of The Lancet add to the existing evidence about the comparative effects of commonly used antihypertensive regimens. The INSIGHT and NORDIL trials each compared outcomes among patients assigned treatment with regimens based on calcium antagonists (nifedipine GITS and diltiazem, respectively) with outcomes among patients assigned a diuretic-based or beta-blocker-based regimen. Neither study found clear evidence of any difference in the frequencies of the pre-specified primary outcomes (combinations of major cardiovascular events), although both studies observed some differences in cause-specific outcomes. In NORDIL, there was a marginally significant lower risk of stroke with diltiazembased therapy (despite a lesser reduction in blood pressure), but there was no clear evidence of a difference in stroke risk in INSIGHT. Conversely, in INSIGHT, there was a marginally significant excess of heart failure with nifedipine-based treatment, but in NORDIL there was no clear evidence of a difference in heart-failure risk. Furthermore, although fatal myocardial infarctions were commoner with nifedipine-based treatment than with diuretic-based treatment in INSIGHT, in neither study was there a clear difference in total number of major CHD events, although the confidence intervals were wide.
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subjectAbridged Index Medicus ; Adrenergic beta-Antagonists - therapeutic use ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Antihypertensive Agents - pharmacology ; Antihypertensive Agents - therapeutic use ; Antihypertensive drugs ; Blood pressure ; Calcium Channel Blockers - therapeutic use ; Cardiovascular disease ; Cardiovascular Diseases - prevention & control ; Coronary heart disease ; Diuretics - therapeutic use ; Heart failure ; Humans ; Hypertension ; Hypertension - complications ; Hypertension - drug therapy ; Physiological aspects ; Prescription drugs ; Risk Factors ; Stroke (Disease)
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abstractTwo papers published in this issue of The Lancet add to the existing evidence about the comparative effects of commonly used antihypertensive regimens. The INSIGHT and NORDIL trials each compared outcomes among patients assigned treatment with regimens based on calcium antagonists (nifedipine GITS and diltiazem, respectively) with outcomes among patients assigned a diuretic-based or beta-blocker-based regimen. Neither study found clear evidence of any difference in the frequencies of the pre-specified primary outcomes (combinations of major cardiovascular events), although both studies observed some differences in cause-specific outcomes. In NORDIL, there was a marginally significant lower risk of stroke with diltiazembased therapy (despite a lesser reduction in blood pressure), but there was no clear evidence of a difference in stroke risk in INSIGHT. Conversely, in INSIGHT, there was a marginally significant excess of heart failure with nifedipine-based treatment, but in NORDIL there was no clear evidence of a difference in heart-failure risk. Furthermore, although fatal myocardial infarctions were commoner with nifedipine-based treatment than with diuretic-based treatment in INSIGHT, in neither study was there a clear difference in total number of major CHD events, although the confidence intervals were wide.
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doi10.1016/S0140-6736(00)02521-6