Diuretics Best for Hypertension and Metabolic Syndrome

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"The magnitude of excess risk of end-stage renal [kidney] disease [70 percent], heart failure [49 percent] and stroke [37 percent] and the increased risk of combined cardiovascular disease and combined coronary heart disease strongly argue against the preference of ACE inhibitors over diuretics as the initial therapy in black patients with metabolic syndrome. Similar high risk was noted for those randomized to the alpha-blocker versus the diuretic."

The researchers concluded that the findings "fail to provide support for the selection of alpha-blockers, ACE inhibitors, or calcium channel blockers over thiazide-type diuretics to prevent cardiovascular or renal outcomes in patients with metabolic syndrome, despite their more favorable metabolic profiles."

The study, which received support from Pfizer Inc., was published in the Jan. 28 issue of the Archives of Internal Medicine.

More information

The American Academy of Family Physicians has more about metabolic syndrome.