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Marvin Moser, MD

Arch Intern Med. 2001;161:1140-1144.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

RESULTS OF recent trials in the management of hypertension indicate that an update of recommendations for initial therapy may be indicated.^1-9

In 1997, the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-VI)¹⁰ recommended that diuretics or ß-blockers be chosen as initial therapy if lifestyle modifications failed to reduce blood pressure to goal levels, unless there were specific or compelling reasons to use other drugs. At that time, the decision was based on the fact that, other than 1 or 2 studies, all of the placebo-controlled morbidity and mortality outcome clinical trials had used diuretics or ß-blockers as initial treatment. Results had been impressive, with a decrease of 38% in strokes, 16% in coronary heart disease events, and more than 40% in the occurrence of heart failure.^11-12 One trial, the Systolic Hypertension Europe (Syst-Eur) trial, had used nitrendipine, . . . [Full Text of this Article]

TRIALS WITH LITTLE APPARENT DIFFERENCE IN OUTCOME REGARDLESS OF THERAPY


TRIALS WITH NO OVERALL DIFFERENCE IN OUTCOME BUT SOME DIFFERENCES BETWEEN DRUGS

TRIALS IN WHICH SPECIFIC MEDICATIONS IMPROVED OUTCOME MORE THAN OTHERS

THE CCB DEBATE

WHAT TREATMENT SHOULD BE RECOMMENDED NOW?

SHOULD RECOMMENDATIONS BE CHANGED?

HOW DO CCBs, ACEIs, AND ANGIOTENSIN RECEPTOR BLOCKERS FIT IN THE TREATMENT ALGORITHM?
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