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| |  Some Popular Blood Pressure Medications Work Better than Others ORANGE COUNTY, Calif., Nov. 10, 1996 -- Physicians know that reducing high blood pressure reduces the risk of heart attack, but selecting the right blood pressure medication can be a challenge. There are many available, but not all of them work equally well in all people. A new study, comparing three popular blood pressure-lowering drugs, Ziac(R), Norvasc(R) and Vasotec(R), demonstrated that: * Ziac is more effective at controlling blood pressure than Norvasc and Vasotec; * Side effects associated with Ziac, Norvasc and Vasotec are similar to placebo. Ziac is a combination of two drugs in low doses (dual therapy), each working in a different way to lower blood pressure. Norvasc and Vasotec each contain only one drug in a standard dose (monotherapy). "The advantage of dual therapy, such as Ziac, is that the two component drugs work together to control blood pressure more effectively. Because each component drug is a lower-than-standard dose, there is no increase in side effects, such as headache and fatigue, or other unwanted outcomes such as changes in cholesterol, triglycerides, blood sugar or potassium -- which often come along with higher doses," said Joel Neutel, M.D., principal investigator of the study. In the study, 323 patients with high blood pressure who were enrolled in the study were given escalating doses of Ziac, Norvasc, Vasotec or placebo. Results demonstrated that 77% of patients on Ziac achieved control of their blood pressure, compared to 56% of patients on Norvasc and 44% of patients on Vasotec. The randomized, double-blind, multicenter study was presented today in New Orleans during the Annual Meeting of the American Heart Association by Dr. Neutel, who is Director of Research at the Orange County Heart Institute and Research Center. It will be published in the November edition of "Cardiovascular Reviews and Reports." "This study suggests that prescribing a low-dose combination drug, such as Ziac, for patients with hypertension may lower their blood pressure more than Norvasc or Vasotec and does not increase side effects or metabolic changes," said Dr. Neutel. "Traditionally, physicians have treated high blood pressure by prescribing a single drug at the lowest dose, and then increasing the dose, as needed, to control the blood pressure," said Dr. Neutel. "Even when the maximum dose is reached, only about half of all patients respond, necessitating the addition of a second drug which may be associated with an increase in side effects and in cost." Ziac reduced systolic blood pressure by an average 14.5 points (mmHg), and diastolic (heart at rest) blood pressure by an average of 12.7 mmHg; Norvasc reduced systolic blood pressure by an average 11.8 mmHg, and diastolic blood pressure by an average of 9.9 mmHg; Vasotec reduced systolic blood pressure by an average 9.8 mmHg, and diastolic blood pressure by an average of 9.0 mmHg. Side effects and metabolic changes were no different with Ziac than with the two other agents. More than 50 million Americans -- one in every four adults -- suffer from high blood pressure, or hypertension. According to the American Heart Association, about 21% of them control it with medication; another 27% are on medication but their hypertension remains uncontrolled; 17% are not on any medication; and 35% unaware that they have hypertension. Hypertension is defined as systolic (while heart is beating) blood pressure of equal to or greater than 140 mmHG, and/or a diastolic (between heart beats) blood pressure of equal to or greater than 90 mmHG. Ziac (bisoprolol fumarate/hydrochlorothiazide), Norvasc (amlodipine) and Vasotec (enalapril) represent three of the most widely proscribed categories of anti-hypertensive drugs. Ziac is a low-dose, combination diuretic/beta blocker; Norvasc is a calcium channel blocker; and Vasotec is an angiotensin converting enzyme (ACE) inhibitor. Diuretics and beta blockers are the preferred initial therapy for the treatment of hypertension by the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure, a panel of experts assembled by the National Heart, Lung and Blood Institute. Ziac(R) is co-marketed by Wyeth-Ayerst Laboratories and Procter & Gamble Pharmaceuticals; Norvasc is marketed by Pfizer Inc. and Vasotec(R) is marketed by Merck & Co. In addition to his role as Director of Research, Orange County Heart Institute and Research Center, Dr. Neutel is Assistant Clinical Professor of Medicine, University of California, Irvine, and Chief of Hypertension, Veteran's Administration Hospital, Long Beach, California.
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