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Diuretics Better at Preventing Heart Failure
 Diuretic
medications are more effective than other high blood pressure medications in
preventing heart failure, at least in the short term, according to a new data
analysis of a study from NIH's National Heart, Lung, and Blood Institute called
the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial
(ALLHAT).
High blood pressure (or hypertension) is the leading risk factor for heart failure,
a condition where the heart is weakened and does not effectively pump blood throughout
the body. Many drugs have been developed in recent years to treat the condition.
ALLHAT was launched in part to compare the effects of a diuretic (sometimes referred
to as a "water pill") with three newer, more costly blood pressure-lowering drugs:
a calcium channel blocker, an angiotensin converting enzyme (ACE) inhibitor and
an alpha-adrenergic blocker.
Previous reports from ALLHAT have shown that all four of the drugs are effective
in lowering blood pressure. The alpha-adrenergic blocker arm of the study was
stopped, however, because those on the drug had 25% more cardiovascular problems
and were twice as likely to be hospitalized for heart failure as users of the
diuretic.
The new analysis was published in the May 9 online edition of Circulation.
In the first year of treatment, participants who received ACE-inhibitors or calcium
channel blockers were twice as likely to be hospitalized or die from heart failure
than those who were taking a diuretic. In later years, the differences between
the study groups were reduced; the rate of developing serious heart failure resulting
in death or hospitalization was about the same for participants taking ACE-inhibitors
or diuretics, while those on calcium channel blockers had a 22% higher risk.
Diuretics are the least costly of these medicines and appear to be the most
effective. However, if you're being treated for high blood pressure, do
not make any changes without first talking with your doctor. Every drug has multiple effects,
and their benefits have to be weighed against their risks to find the best treatment
for each person.
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