Treatment of Hypertension: A Review.
Study Goal
The researchers aimed to evaluate the role of calcium channel blockers (such as amlodipine) as first-line therapy for hypertension and their efficacy in reducing cardiovascular disease risk.
Results Summary
The study found that calcium channel blockers, when used as part of first-line antihypertensive therapy, effectively lower blood pressure and reduce the risk of cardiovascular disease events by approximately 20% to 30% with a 10 mm Hg reduction in systolic blood pressure.
Population
Adults with hypertension, including those under 65 years and those 65 years or older.
Effective Dosage
Not specified in the abstract.
Duration
Not specified in the abstract.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
weight loss | decrease | blood pressure | people with hypertension | - | BP-lowering effects | #1 |
healthy dietary pattern that includes low sodium and high potassium intake | decrease | blood pressure | people with hypertension | - | BP-lowering effects | #2 |
physical activity | decrease | blood pressure | people with hypertension | - | BP-lowering effects | #3 |
moderation or elimination of alcohol consumption | decrease | blood pressure | people with hypertension | - | BP-lowering effects | #4 |
lifestyle modification | increase | pharmacologic therapy | people with hypertension | - | enhance the efficacy | #5 |
BP lowering | decrease | CVD morbidity and mortality | - | - | reduce the risk | #6 |
SBP reduction of 10 mm Hg | decrease | CVD events | - | approximately 20% to 30% | decreases risk | #7 |
dietary sodium reduction and potassium supplementation | no change | hypertension | people with hypertension | - | first-line therapy | #8 |
IMPORTANCE: Hypertension, defined as persistent systolic blood pressure (SBP) at least 130 mm Hg or diastolic BP (DBP) at least 80 mm Hg, affects approximately 116 million adults in the US and more than 1 billion adults worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (coronary heart disease, heart failure, and stroke) and death. OBSERVATIONS: First-line therapy for hypertension is lifestyle modification, including weight loss, healthy dietary pattern that includes low sodium and high potassium intake, physical activity, and moderation or elimination of alcohol consumption. The BP-lowering effects of individual lifestyle components are partially additive and enhance the efficacy of pharmacologic therapy. The decision to initiate antihypertensive medication should be based on the level of BP and the presence of high atherosclerotic CVD risk. First-line drug therapy for hypertension consists of a thiazide or thiazidelike diuretic such as hydrochlorothiazide or chlorthalidone, an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker such as enalapril or candesartan, and a calcium channel blocker such as amlodipine and should be titrated according to office and home SBP/DBP levels to achieve in most people an SBP/DBP target (<130/80 mm Hg for adults <65 years and SBP <130 mm Hg in adults ≥65 years). Randomized clinical trials have established the efficacy of BP lowering to reduce the risk of CVD morbidity and mortality. An SBP reduction of 10 mm Hg decreases risk of CVD events by approximately 20% to 30%. Despite the benefits of BP control, only 44% of US adults with hypertension have their SBP/DBP controlled to less than 140/90 mm Hg. CONCLUSIONS AND RELEVANCE: Hypertension affects approximately 116 million adults in the US and more than 1 billion adults worldwide and is a leading cause of CVD morbidity and mortality. First-line therapy for hypertension is lifestyle modification, consisting of weight loss, dietary sodium reduction and potassium supplementation, healthy dietary pattern, physical activity, and limited alcohol consumption. When drug therapy is required, first-line therapies are thiazide or thiazidelike diuretics, angiotensin-converting enzyme inhibitor or angiotensin receptor blockers, and calcium channel blockers.