CHICAGO – Use of calcium-channel blockers, alpha-blockers or angiotensin-converting enzyme (ACE) inhibitors appears to offer no advantages in improving clinical outcomes compared with use of diuretics when treating hypertension among individuals with metabolic syndrome, according to a report in the January 28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. This appears particularly true for black patients.
Patients with hypertension (high blood pressure) and metabolic syndrome are at high risk for the complications of cardiovascular disease, according to background information in the article. The metabolic syndrome was defined as hypertension plus at least two of the following factors: diabetes or pre-diabetes; a body mass index (BMI) of at least 30; high triglyceride levels; or low levels of high-density lipoprotein (“good” cholesterol). Because some medications for high blood pressure (including alpha-blockers, ACE inhibitors and calcium channel blockers) have a favorable metabolic profile—for instance, have more favorable short-term effects on blood glucose or blood cholesterol levels—they have been advocated over other drugs (beta-blockers and diuretics) for the treatment of patients with metabolic syndrome.
Jackson T. Wright Jr., M.D., Ph.D., of University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, and colleagues analyzed data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).