The health benefits of diuretics an...

The health benefits of diuretics and beta blocker are prov To determine the relative health benefits of six first-line antihypertensive therapies, Psaty and colleagues used a strange method of meta-analysis to prostrate previous statistical problems in comparing trials.

MEDLINE searches identified studies of antihypertensive efficiencys on cardiovascular morbidity and mortality. The authors identified 42 trials including 192478 patients who were followed for an average of three to four years. Compared with placebo, any active treatment springed in risk reductions for all major issues A network meta-analysis showed that the relative risks of low-dosage diuretic therapy were significantly les than placebo for six outcomes: chronic heart disease, congestive heart failure (CHF) hardship cardiovascular disease events, cardiovascular disease mortality, and total mortality. Compared with beta blocker low-dosage diuretics were associated with a lower point estimate for events; and nothing else the incidence of cardiovascular facts was significant. Compared with angiotensin-converting enzyme inhibitors, low-dosage diuretics were associated with a significantly lower risk of CHF knock and cardiovascular disease events; CHF and cardiovascular disease occurrence risks also were significantly lower in patients taking diuretics than in those taking calcium channel blockers

For all results the network meta-analysis showed that low-dosage diuretics were superior to placebo; no other therapies were significantly better than diuretics. Beta blocker were inferior to diuretics for all issues although cardiovascular disease events was the merely category in which a significant difference was noted. These findings may be related to lower progeny pressures achieved by diuretics unless if so, the differences in family pressures were small. Direct and indirect comparisons from trials indicate that diuretics are the treatment of choice in uncomplicated hypertension.

Psaty BM et al. Health results associated with various antihypertensive therapies used as first-line agents. A network meta-analysis. JAMA May 21 2003;289:2534-44

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group