Why the study?
Do different classes of antihypertensive agents have varying effects on long-term end-organ damage despite similar blood pressure reduction in patients with hypertension?
Do different classes of antihypertensive agents have varying effects on long-term end-organ damage despite similar blood pressure reduction in patients with hypertension?
Different classes of antihypertensive drugs have distinct effects on end-organ damage such as left ventricular hypertrophy and renal function, independent of their blood pressure-lowering efficacy.
Class-specific end-organ effects beyond BP reduction may inform agent choice in high-risk hypertension; leaves open optimal selection pending prospective outcome trials.
Various antihypertensive agents may reduce blood pressure to a similar degree, yet they produce different outcomes with respect to long-term end-organ damage. Effective antihypertensive therapy can prevent or even reverse established left ventricular hypertrophy. The most rapid and extensive regression occurs with agents that block the reninangiotensin system or reduce entry of calcium into the cells. Other classes of drugs that reliably reverse left ventricular hypertrophy are centrally acting adrenergic inhibitors and beta blockers. The effect of antihypertensive agents on atherosclerosis appears to differ widely with regard to lipid metabolism, insulin sensitivity, and the biology of endothelium and vascular smooth muscle. Hypertension and chronic renal failure (diabetic and nondiabetic) are closely allied, but available antihypertensive agents are not equally potent in reducing intraglomerular pressure.
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Charles J. Kaupke (1995) studied this question.
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