ASCOT results may change hypertension guidelines
Full results from the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure-Lowering Arm (ASCOT-BPLA) were announced at the European Society of Cardiology Congress in Stockholm, Sweden, 3-7 September 2005.
In people with hypertension who were at a moderate risk of developing cardiovascular events, the calcium-channel blocker amlodipine (Istin; Pfizer), with the angiotensin-converting enzyme (ACE) inhibitor perindopril (Coversyl; Servier) as an add-on if needed, was found to be superior to a standard beta-blocker regimen, with risk reductions in all major end points evaluated, including incidence of new-onset diabetes.
Hypertension and diabetes experts have predicted that newly revised guidelines for GPs will recommend that beta-blockers be removed from the British Hypertension Society AB/CD treatment algorithm for patients with uncomplicated hypertension.
Professor Peter Sever, Professor of Clinical Pharmacology and Therapeutics at Imperial College, said that forthcoming guidance was likely to be based on a new rule, with patients under 55 receiving an angiotensin II antagonist or ACE inhibitor and patients over 55 receiving a diuretic as first-line treatment.
Dr George Kassianos, a GP from Bracknell, agreed that a new regimen should now be proposed for GPs, 'but we must remember there are proven benefits for beta-blockers in patients with coronary heart disease, myocardial infarction, certain arrythmias, cardiac failure, anxiety and migraine.'
Potential metabolic effects seen in telmisartan
Preclinical studies show that the angiotensin II receptor blocker telmisartan (Micardis; Boehringer Ingelheim) has a beneficial effect on metabolic parameters including plasma glucose, insulin resistance and lipid abnormalities, through its partial activation of peroxisome proliferator-activated receptor-gamma (PPAR[gamma]). The implications of these findings were discussed at the European Society of Cardiology Congress in Stockholm, Sweden, 3-7 September 2005.
'These preclinical findings are very exciting,' said Professor Ted Kurtz from the University of California. They suggest that telmisartan 'may have a uniquely beneficial metabolic effect,' he added. He concluded by stating the need 'to investigate these effects further in a large scale trial.'
COPYRIGHT 2005 S.B. Communications
COPYRIGHT 2005 Gale Group
Contact
Home
A
Oxytetracycline