Benefits of Hypertension Treatments Largely Similar Across Drug Classes


The differences between antihypertension medication classes were generally small and nuanced in terms of their effect on reducing cardiovascular risks.


Antihypertension treatments showed similar clinical benefits across different medication classes in patients with hypertension, according to a new study.

A systematic review and meta-analysis published in JAMA Network Open compared individual antihypertension medication classes among 248,887 patients with hypertension and no substantial comorbidities.

The studies looked at the efficacy of angiotensin-converting enzyme (ACE) inhibitors, dihydropyridine calcium channel blockers, and diuretics.

According to the results, all medication classes were found to be similarly effective in reducing overall cardiovascular (CV) events (25%), CV death (20%), and stroke (35%) when compared with placebo. Compared with other antihypertension medications, ACE inhibitors were reported to be the most effective in reducing the risk of heart attack (28%), whereas diuretics were found to be most effective in reducing revascularization (33%), according to the study.

However, the overall differences between medication classes were generally small in terms of their associations with reducing CV events, the researchers noted.

“Knowledge of optimal first-line antihypertension medications for the prevention of cardiovascular events and mortality will be important for clinical decision-making,” the researchers wrote in the study. Identifying the most effective treatments for controlling blood pressure and cardiovascular events with the least harmful effects could help guide treatment decisions.

The researchers concluded that further research should examine the associations between antihypertension medications and lifestyle in preventing CV events among patients with hypertension.


1. Wei J, Galaviz KI, Kowalski AJ, et al. Comparison of cardiovascular events among users of different classes of antihypertension medications: A systematic review and network meta-analysis. JAMA Network Open. 2020. Doi: 10.1001/jamanetworkopen.2019.21618

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