‘Water Pills’ May Cut Heart Risks in Diabetes
June 27, 2005 — Water pills may work as well as other commonly used high
blood pressure pills to protect the hearts of people with type 2 diabetes.
The researchers say they found “no evidence” that newer, more costly
high blood pressure medications were better at preventing heart disease deaths
or heart attacks than water pills, also called diuretics.
The findings were complex and “must be interpreted with caution,”
they write in the Archives of Internal Medicine.
They say the type of diuretics they studied “should be strongly
considered” as initial drug therapy for patients with high blood pressure
and type 2 diabetes or prediabetes.
About High Blood Pressure
Nearly one in three U.S. adults has high blood pressure. But almost a third
of them don’t know it, says the American Heart Association (AHA). High blood
pressure affects nearly 50 million people in the U.S. and approximately 1
billion worldwide, according to the National Heart, Lung and Blood Institute
(NHLBI).
Uncontrolled high blood pressure can be very dangerous. It can raise the
risk of heart attack, stroke, heart failure, or kidney failure, says the
AHA.
The relationship between blood pressure and heart disease risk is a
continuous and consistent one, says the NHLBI. The higher the blood pressure,
the greater the risk of heart attack, heart failure, stroke, and kidney
disease. People with diabetes and high blood pressure have approximately twice
the risk of complications compared with people who have high blood pressure
alone.
Medications can help curb high blood pressure and reduce the risk of
complications from the disease. A healthy lifestyle — including exercise and
good nutrition — can also make a difference.
High Blood Pressure and Diabetes
“Almost three out of every four persons with type 2 diabetes has [high
blood pressure],” says Paul Whelton, MD, MSc, in a news release.
That puts those people at “substantial risk” for heart disease, he
says.
Whelton worked on the diuretic study. He is Tulane University’s senior vice
president for health sciences.
Study’s Structure
Whelton’s study included more than 31,500 adults aged 55 and older.
All had high blood pressure and at least one other heart disease risk
factor. More than 13,000 had type 2 diabetes or an abnormal fasting blood
sugar.
Patients were assigned to take one of three drugs initially:
A diuretic called chlorthalidone
An ACE inhibitor called lisinopril (Prinivil or Zestril)
A calcium channel blocker called Norvasc
They were tracked for five years, on average. Most people with diabetes and
high blood pressure require more than one drug to achieve a target blood
pressure goal of less than 130/80.
