Generic high blood pressure drugs get a boost





Generic thiazide diuretic –type high blood pressure drugs got a thumbs up from researchers, reporting at a recent international scientific meeting on hypertension in China earlier in August 2010. Long-term results from the scientific study ALLHAT (The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) - which compared the thiazide diuretic chlorthalidone with the calcium channel blocker amlodipine (Norvasc, Istin) and the ACE inhibitor lisinopril (Prinivil, Zestril) - found that after a mean of 8.8 years, the outcomes (in terms of major cardiovascular disease events like heart failure and were almost identical.

Lead researcher Paul Whelton of Loyola University Medical Centre said the results showed “some diminution of the differences between treatment effects of chlorthalidone and the newer agents, but provided no evidence that either amlodipine or lisinopril was superior to chlorthalidone in preventing major cardiovascular disease events".

Comment

The media have been quite excited about this, it is good news and hopefully will result in more doctors prescribing thiazides and savings for patients. Thiazide diuretics are already one of the most commonly recommended first-line high blood pressure drugs for most situations. They may be old but they are holding their own against the new(ish) kids on the block.

There are some caveats though. For example, now there are generic versions of the major calcium channel blockers and ACE inhibitors (including amlodipine and lisinopril) so the cost difference will be reduced. Secondly there may be significant reasons for being prescribed other classes of drugs. Antihypertensives often show advantages in different situations, for example ACE inhibitors and angiotensin receptor blockers help to protect the kidneys, so patients with evidence of kidney damage may benefit from these. Third, side-effects should also be considered.

If you feel you might be a candidate for change, you must talk to your doctor about this.

The bottom line was well put by Stephen L. Kopecky, MD, of the Mayo Clinic in Rochester, Minn. Who is reported explaining that it is not the high blood pressure drugs used but the control of blood pressure that matters most. "It can be lifestyle, it can be exercise, it can be weight loss, it can be not smoking and drinking , . . what we're finding over and over again is it really is important getting your numbers under control no matter how you do it."

There's that control word again!





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