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
de Lorgeril M, Renaud S, Mamelle N.
et al. Mediterranean
alpha-linolenic acid-rich diet in secondary prevention of coronary
heart disease. Lancet.1994;343:1454-1459.
Ascherio A, Rimm EB, Hernan MD.
et al. Intake of
potassium, magnesium, calcium, and fiber and risk of stroke among US
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
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
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.