JOIN USPaul Whelton is president and CEO of Loyola University Health System and chairman of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heat Attack Trial (ALLHAT), which has examined the comparative value of different blood pressure-lowering medications.
In 2002, researchers reported that among patients followed for four-to-eight years, the diuretic was better than the calcium channel blocker in preventing heart failure and better than the ACE inhibitor in preventing stroke, heart failure and overall cardiovascular disease.
But the diuretic still was superior in two measures: Compared with the diuretic group, the ACE inhibitor group had a 20 per cent higher death rate from stroke, and the calcium channel blocker group had a 12 percent higher rate of hospitalizations and deaths due to heart failure.
Diuretics, sometimes called “water pills,” are the traditional medications for high blood pressure. They cause kidneys to remove sodium and water from the body, thereby relaxing blood vessel walls.
ACE inhibitors such as lisinopril (brand names, Prinivil and Zestril) decrease chemicals that tighten blood vessels. Calcium channel blockers such as amlodipine (brand name, Norvasc) relax blood vessels. Diuretics cost $25 to $40 per year, while newer brand-name hypertension drugs can cost $300 dollars to $600 per year.