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A study that appeared in the December 2002 issue of JAMA showed that treatments based on ACE inhibitors and calcium antagonists were less effective than diuretics. This data was destined to revolutionize arterial hypertension therapy options.
In this study, circa 35,000 people were monitored for 5 years in order to compare the effectiveness of various medicines:
- ACE inhibitors (from 10 to 40 mg per day of lisinopril, distributed in Italy under the name of Zestril, Alapril, Prinivil);
- Calcium antagonists (from 2,5 to 10 mg per day of amlodipina, distributed in Italy under the name of Norgasc, Monoprina, Antacal);
- Thiazide diuretics (from 12,5 to 25 mg per day of chlortalidone, available in Italy as Igroton).
Another medicine (doxazosin) that was initially taken into consideration, was eliminated a few months after the beginning of the study because it produced a marked increase in serious side effects.
Even though ACE inhibitors and calcium antagonists proved more effective than the placebos during the tests, the diuretic was most effective in reducing blood pressure. In addition, in the case of the first two medicines, there were more reported cases of heart failure and other cardiac complications.
Since the main role of the diuretic is that of facilitating the elimination of excess water that is retained by the body, the same function can often be performed in a more effective and safe manner through a low-salt diet.
Another important consideration is that one month of treatment with a diuretic costs around 1,38 Euro while treatment with ACE inhibitors costs around 26 Euro and calcium antagonists costs around 36,51 Euro. One wonders whose interests are actually being pursued, since a widespread approach to hypertension therapy promotes drugs that have proven to be less effective.
Even though you must always discuss therapy with your doctor and should never interrupt it without his consent, a low-salt, cost-free diet is the first instrument available to those suffering from hypertension to help keep high blood pressure under control. Whether used alone or in combination with the therapy prescribed by your doctor, this strategy is an effective aid.
(Other useful information about the low-salt diet is available in the articles “Salty foods can cause breathing difficulty” and “Are you eating too much calcium?” )
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