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Contempo 1999 |

Advances in the Treatment of Hypertension

Thomas G. Pickering, MD, DPhil
JAMA. 1999;281(2):114-116. doi:10.1001/jama.281.2.114.
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The past year has seen a flurry of publications of large-scale clinical trials that may have major impact on the treatment of hypertensive patients. Most of these appeared after the November 1997 publication of the latest report of the Joint National Committee (JNC VI)1 and generally support its recommendations.

The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure [published correction appears in Arch Intern Med. 1998;158:573]. Arch Intern Med.1997;157:2413-2446.
Appel LJ, Moore TJ, Obarzanek E.  et al. A clinical trial of the effects of dietary patterns on blood pressure: DASH Collaborative Research Group. N Engl J Med.1997;336:1117-1124.
de Lorgeril M, Salen P, Martin JL, Monjaud I, Boucher P, Mamelle N.Mediterranean dietary pattern in a randomized trial: prolonged survival and possible reduced cancer rate. Arch Intern Med.1998;158:1181-1187.
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Ascherio A, Rimm EB, Hernan MD.  et al. Intake of potassium, magnesium, calcium, and fiber and risk of stroke among US men. Circulation.1998;98:1198-1204.
Appel LJ, Espeland M, Whelton PK.  et al. Trial of Nonpharmacologic Intervention in the Elderly (TONE): design and rationale of a blood pressure control trial. Ann Epidemiol.1995;5:119-129.
Philipp T, Anlauf M, Distler A, Holzgreve H, Michaelis J, Wellek S.Randomised, double blind, multicentre comparison of hydrochlorothiazide, atenolol, nitrendipine, and enalapril in antihypertensive treatment: results of the HANE study: HANE Trial Research Group. BMJ.1997;315:154-159.
Hansson L, Hedner T, Lindholm LH.  et al. The Captopril Prevention Project (CAPPP) in hypertension: final results. J Hypertens.1998;16(suppl 2):S22.
Pahor M, Guralnick JM, Salivc ME, Corti M-C, Carbonin P, Havlik RJ.Do calcium channel blockers increase the risk of cancer? Am J Hypertens.1996;9:695-699.
Lever AF, Hole DJ, Gillis CR.  et al. Do inhibitors of angiotensin-I-converting enzyme protect against risk of cancer? Lancet.1998;352:179-184.
Hole DJ, Gillis CK, McCallum IR.  et al. Cancer risk of hypertensive patients taking calcium antagonists. J Hypertens.1998;16:119-124.
Messerli FH, Grossman E, Goldbourt U.Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? a systematic review. JAMA.1998;279:1903-1907.
Pahor M, Shorr RI, Somes GW.  et al. Diuretic-based treatment and cardiovascular events in patients with mild renal dysfunction enrolled in the Systolic Hypertension in the Elderly Program. Arch Intern Med.1998;158:1340-1345.
Curb JD, Pressel SL, Cutler JA.  et al. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension: Systolic Hypertension in the Elderly Program Cooperative Research Group [published correction appears in JAMA. 1996;277:1356]. JAMA.1996;276:1886-1892.
Staessen JA, Fagard R, Thijs L.  et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension: the Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet.1997;350:757-764.
Forette F, Seux M-L, Staessen J.  et al. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet.1998;352:1347-1351.
Estacio RO, Jeffers BW, Hiatt WR, Biggerstaff SL, Gifford N, Schrier RW.The effect of nisoldipine as compared with enalapril on cardiovascular outcomes in patients with non-insulin-dependent diabetes and hypertension. N Engl J Med.1998;338:645-652.
Tatti P, Pahor M, Byington RP.  et al. Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diabetes Care.1998;21:597-603.
UK Prospective Diabetes Study Group. Efficacy ofatenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 39. BMJ.1998;317:713-720.
Hansson L, Zanchetti A, Carruthers SG.  et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial: HOT Study Group. Lancet.1998;351:1755-1762.
UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ.1998;317:703-713.


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