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ISHIB: ACE Inhibitor Plus Diuretic Combo Best for American Indians By Lynn Haley Special to DG News LAS VEGAS, NV -- July 11, 2001 -- Angiotensin-converting enzyme (ACE) inhibitors combined with diuretics can successfully control blood pressure in American Indians. The results, from a study by researchers at the University of Oklahoma Medical Centre, was presented at the 2001 meeting of the International Society of Hypertension in Blacks held here July 8th-12th. Cardiovascular disease is the leading cause of death among American Indians. Researchers from the multi-centre Strong Heart Study (SHS) assessed risk factors in 13 tribes in Arizona, North and South Dakota, as well as Oklahoma. The total number of patients who entered the study was 2,254 women and 1,384 men returning for a second SHS examination between 1993 and 1995. Comprehensive exams included non-invasive cardiovascular disease testing and physical examination, which included measurement of blood pressure and detailed medical history. Forty-seven percent of patients had hypertension (n=1698), and 1,114 were taking anti-hypertensives. Patients were taking one, two or three medications (71 percent, 25 percent and 4 percent, respectively). Drug classes included diuretics, calcium channel blockers (CCB), beta-blockers (BB) and ACE inhibitors. ACE inhibitors were the most prescribed drugs (49 percent), followed by CCB agents (24 percent) and diuretics. The most common dual therapy was the ACE inhibitor-diuretic combination (47 percent), which achieved a high level of blood pressure control (systolic <140 mm Hg, diastolic <90 mm Hg) rate of 65 percent. This was followed by single and triple therapies (54 percent and 44 percent, respectively). Of the monotherapies, diuretics provided the best hypertension control rates in 63 percent of diabetics and 68 percent of non-diabetics. Researchers concluded that the frequent use of ACE inhibitors either alone or in combination is due to the high prevalence of diabetes in the American Indian population. As a result, the dual therapy of ACE inhibitor-diuretics combination was particularly useful in achieving blood pressure control. E-mail this page to a friend or colleague! To print, use this version