FOR IMMEDIATE RELEASE
March 5, 1998
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Sarah Ellis
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Hypertension Medication May Decrease Risk of Heart Attacks in Diabetics
People with Type 2 diabetes and high-blood pressure had a decreased incidence of heart attacks with the use of an angiotensin-converting enzyme (ACE) inhibitor when compared with a calcium channel blocker to control their hypertension, according to a study published in the March 5 issue of theNew England Journal of Medicine. The study was conducted by researchers at the University of Colorado Health Sciences Center.
In a five-year study of 470 adult patients with Type 2 diabetes-- also known as non-insulin-dependent or adult-onset diabetes -- and hypertension, researchers compared the effects of the long-acting calcium channel blocker nisoldipine with the ACE inhibitor enalapril in the prevention and/or progression of diabetic complications. Calcium channel blockers are the most commonly prescribed medication in the United States for the control of high blood pressure.
While both drugs showed similar control of blood pressure, blood glucose and cholesterol, enalapril was associated with a lower rate of myocardial infarctions, or heart attacks. Of the 235 patients taking enalapril, five had heart attacks, compared with 25 of the 235 patients on nisoldipine. The results occurred independent of any differences in gender, age, blood sugar, cholesterol, obesity, smoking habits or blood pressure levels.
"This is an important finding that indicates that adult patients with diabetes and high blood pressure should probably be treated initially with an ACE inhibitor to prevent heart attacks, a common cause of death in these patients," said Robert Schrier, MD, chairman of the Department of Medicine at the CU-Health Sciences Center and principal investigator of the study. "However, this study does not answer questions raised by previous retrospective and controversial studies about short-acting calcium channel blockers and their association with increased mortality."
Raymond Estacio, MD, assistant professor at the CU-Health Sciences Center and Denver Health and medical director of the study said, "These findings are important, but further controlled studies are needed to confirm the findings. Patients concerned about their blood pressure medication should talk to their doctors."
The study was conducted at the Colorado Prevention Center, an affiliate of the University of Colorado Health Sciences Center and a regional clinical research center for the treatment of diabetes and cardiovascular diseases. The study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health and Bayer, AG.
The published findings are part of the Appropriate Blood Pressure Control in Diabetes (ABCD) trial, which began in 1991 and was designed to determine the optimal level of blood pressure control to prevent and/or slow down the progression of complications associated with Type 2 diabetes.
The University of Colorado Health Sciences Center is one of four campuses in the University of Colorado system. Located in Denver, Colo., the campus includes schools of medicine, nursing, pharmacy, and dentistry, a graduate school and two hospitals.
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