Women's Health Initiative: Antihypertensives and Cardiovascular Death

Study characteristics: 1) 15,787 hypertensive postmenopausal women without other known cardiovascular disease 2) mean follow-up 6 years Treatment: 1) monotherapy a) Ca⁺² channel blocker b) beta-blocker c) ACE inhibitor d) diuretic 2) combination therapy (4493 women) a) diuretic + Ca⁺² channel blocker b) diuretic + beta-blocker c) diuretic + ACE inhibitor Outcome: death from cardiovascular disease Results: 1) monotherapy a) Ca+ channel blocker associated with greater risk than diuretic (HR = 1.55) b) beta-blocker & ACE inhibitor not associated with increased risk relative to diuretic 2) combination therapy a) combination of Ca+ channel blocker + diuretic associated poorest outcome (HR = 1.85 relative to beta-blocker + diuretic) b) ACE inhibitor + diuretic did not differ from beta-blocker + diuretic

References

Journal Watch 25(2):15, 2005 Wassertheil-Smoller S, Psaty B, Greenland P, Oberman A, Kotchen T, Mouton C, Black H, Aragaki A, Trevisan M. Association between cardiovascular outcomes and antihypertensive drug treatment in older women. JAMA. 2004 Dec 15;292(23):2849-59. PMID: 15598916