Hypertension Therapy and Risk of Coronary Heart Disease: How Do Antihypertensives Affect Metabolic Factors?

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Abstract

A recent meta-analysis of hypertension treatment trials demonstrated a marked reduction in the incidence of cerebrovascular disease, but a less pronounced reduction in coronary heart disease. Treatment consisted mainly of diuretics and β-blockers, and this paper discusses the possible influences of their metabolic side effects on coronary risk factors compared with newer agents: angiotensin-converting enzyme (ACE) inhibitors, selective α<sub>1</sub>-adrenoceptor inhibitors and calcium channel blockers. Several studies are underway to compare the effect of these compounds with diuretics and β-blockers with respect to long-term cardiovascular morbidity and mortality. Until the results of these studies are available, young patients (i.e. < 60-65 years) at high risk of coronary heart disease, especially patients with the insulin resistance syndrome or diabetes mellitus, should in our opinion be treated with ACE-inhibitors, selective α<sub>1</sub>-adrenoceptor inhibitors or calcium channel blockers.

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Author and article information

Journal

Journal ID (publisher-id): CRD

Journal ID (nlm-ta): Cardiology

Journal ID (doi): 10.1159/issn.0008-6312

Title: Cardiology

Publisher: S. Karger AG

ISSN (Print): 0008-6312

ISSN (Electronic): 1421-9751

Publication date Subscription-year: 1995

Publication date (Print): 1995

Publication date (Electronic): 18 November 2008

Volume: 86

Issue: 2

Pages: 89-93

Affiliations

Department of Internal Medicine, Medical Clinic and Clinical Research Center, Ullevål Hospital, Oslo, Norway

Article

Publisher ID: 176845 Other ID: Cardiology 1995;86:89–93

DOI: 10.1159/000176845

PubMed ID: 7728812

SO-VID: 2c44637e-9e85-4a9d-8df6-16708f2dda2f

License:

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 06 September 1994

Date accepted : 19 September 1994

Page count

Pages: 5

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