Pharmacologic and nutritional treatment of mild hypertension: changes in cardiovascular risk status

Drugs used to treat hypertension, abnormally high blood pressure, may actually increase the risk of developing cardiovascular disease, which affects the major blood vessels supplying the heart. Adverse effects of antihypertensive agents on cardiovascular risk factors may be particularly important in patients with less severe hypertension, because most deaths due to hypertension occur among people with moderate hypertension. The effects of diet and drug therapy for mild hypertension on cardiovascular risk factors were assessed in 692 patients with mild hypertension and whose weight was between 110 and 160 percent of ideal. Nine different therapy regimens were developed using combinations of the usual, low sodium-high potassium weight loss diets and the antihypertensive agents, chlorthalidone and atenolol, or else a placebo or substance with no known therapeutic effect. The cardiovascular risk associated with each of the nine different treatment combinations was evaluated after a period of six months. A decrease in blood pressure was associated with a reduction in cardiovascular risk in all treatment groups except that in which the usual diet was combined with chlorthalidone, which produced increased cholesterol levels. Antihypertensive agents combined with a weight loss diet were associated with the lowest risk of cardiovascular disease. The findings show that diet and antihypertensive agents have different effects on cardiovascular risk, and dietary therapy, particularly weight reduction, helped to reduce cardiovascular risk. (Consumer Summary produced by Reliance Medical Information, Inc.)