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| |  Vasotec (Enalapril) Improves Long-Term Outcomes In Hypertensive Patients MONTREAL, QC -- December 17, 2002 -- A new analysis from a retrospective review of the United Kingdom General Practice Research Database (GPRD) showed that first line treatment with angiotensin converting enzymes inhibitors (ACEI) including Vasotec® (enalapril), improved long-term outcomes in hypertensive patients and that ACE inhibitor therapy led to significant reductions in cardiovascular mortality as well as cardiovascular events. Moreover, first-line treatment with ACE inhibitors including enalapril was associated with significant 37% reduction in coronary heart disease and 13% reduction in cerebrovascular events. Of the 11,249 ACE inhibitor treated patients, 8.4% developed coronary heart disease (which included angina) whereas 15.2% of patients in the calcium channel blocker treated group developed coronary heart disease (including angina). Additionally, patients treated with ACE inhibitors also had a significantly lower incidence of cerebrovascular events of 4.4% while 6.9% of patients treated with calcium channel blockers experienced cerebrovascular events. The incidence of left ventricular failure in patients treated with ACE inhibitors was 5.3% and 8.1% for patients treated with calcium channel blockers. The results were presented last month at the American Heart Association (AHA) meeting in Chicago. "The results could not be explained by differences in blood pressure or other risk factors in the two patient groups", said Dr. Gordon McInnes, lead investigator for the GPRD study, Gardiner Institute, Western Infirmary, Glasgow, UK. "There were also trends in favor of ACE inhibition for coronary heart disease even if symptomatic angina was excluded, as well as for left ventricular failure. It should be noted that enalapril was the ACE inhibitor most frequently used in this study." A majority of patients on an ACE inhibitor were taking enalapril (40%), with smaller proportions of patients taking captopril (28%), lisinopril (28%), or ramipril (7%). About the United Kingdom General Practice Research Database (GPRD) The GPRD is the world's largest computerized database of anonymized patient records from general practice, and contains more than 35 million patient years of data. The researchers identified approximately 25,000 hypertensive patients with two blood pressure measurements of 160/90mmHg or GP's stated diagnosis of hypertension who were receiving hypertension treatment at the UK's 80 largest general practices during 1988 to 1998. This permitted an average follow-up of six years. The investigators only chose those cases involving first-line use of either ACE inhibitors (n=11,249) or calcium channel blockers (n=12,494) - none of the patients had received any previous antihypertensive treatment and none were selected after failing to respond to other agents. The cardiovascular morbidity rates in ACE inhibitor treated and CCB treated patients were compared by calculating the relative hazard ratio (RHR) with 95% confidence intervals using the Cox proportional hazard model. Appropriate adjustments were made with respect to age, gender, and age of entry into the study. The analysis also excluded those with evidence of previous cardiovascular or cerebrovascular disease, chest pain, or angina. The results, which supported earlier findings, strongly suggested that observational studies in large, well-documented populations treated in the usual clinical setting might allow differentiation of the cardiovascular protective effects of antihypertensive drugs. The present prospectively collected, retrospectively analyzed study provides exciting new data with regards to treatments with ACE inhibitors or CCBs in preventing cardiovascular morbidity in hypertensive patients. About Hypertension Hypertension is believed to be caused, in part, by the formation of a substance called angiotensin II, which is the body's most potent constrictor of blood vessels and mediates the retention of sodium and water. Between 20 to 25% of Canadians suffer from high blood pressure and one third of these men and women don't know it. Furthermore, 57% of Canadians over 65 suffer from hypertension.1 If hypertensive patients are not treated properly, they can suffer severe consequences such as heart attack, stroke and death. High blood pressure increases overall cardiovascular risk by 2 to 3 fold. Discovering today for a better tomorrow Merck Frosst Canada & Co. is one of the country's leading research-based pharmaceutical companies. The Merck Frosst Centre for Therapeutic Research, one of the largest biomedical research facilities in Canada, has a mandate to discover new therapies for the treatment of respiratory, inflammatory and other diseases. Discoveries such as VIOXXÒ (rofecoxib) and SINGULAIRÒ (montelukast sodium) were made in Canada by our researchers. In 2001, the company invested nearly $120 million in research and development in Canada. For its part, Merck Frosst Canada Ltd. markets a broad range of innovative products to improve human health. Merck Frosst Canada & Co. and Merck Frosst Canada Ltd. are affiliated companies of Merck & Co., Inc. of Whitehouse Station, New Jersey. Merck & Co., Inc. is a publicly traded company on the New York Stock Exchange under the symbol MRK.
®Registered trademarks of Merck & Co., Inc., Used under license.
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SOURCE: Merck Frosst Canada Ltd.
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