Q&A

Use CCBs as last resort in treatment of hypertension

J Fam Pract. 2005 March;54(3):199-206
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  • CLINICAL QUESTION: In the treatment of adults with hypertension, which other drug class added to diuretics most effectively reduces adverse cardiovascular events?
  • STUDY DESIGN: Cohort (prospective)
  • SETTING: Population-based
  • SYNOPSIS: Evidence shows that diuretics are equal to or superior to other agents as first-line therapy for most patients with hypertension. More than 1 drug class, however, is frequently required to control hypertension. It is unclear which other drug classes, added to diuretics, optimally reduce adverse cardiovascular events.
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BOTTOM LINE

In women with hypertension and no history of cardiovascular disease (CVD), a regimen of a diuretic plus either a beta-blocker or angiotensin-converting enzyme (ACE) inhibitor reduces the risk of CVD mortality compared with a diuretic plus calcium channel blocker. The evidence continues to mount that calcium channel blockers should be the agent of last resort in the treatment of most patients with hypertension. (LOE=2b–)

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