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Study finds diuretics cut risk of heart failure


May reduce heart's workload

July 15, 1997
Web posted at: 11:05 p.m. EDT (0305 GMT)

ATLANTA (CNN) -- More people go to the hospital each year for heart problems than any other ailment, and half of those people die within five years. But a new study suggests that some heart problems can be prevented with diuretics that cost as little as $6 a month.

In a study reported Tuesday in the Journal of the American Medical Association, researchers found that diuretics used to treat people with high blood pressure significantly reduced the risk of heart failure among older patients.

Heart failure afflicts more than 2 million people each year in the United States, and results in approximately one million hospitalizations.

CNN's Rhonda Rowland reports
icon 2 min., 2 sec. VXtreme streaming video

Researchers tracked 4,376 people age 60 or older who participated in the Systolic Hypertension in the Elderly Program (SHEP). Participants were randomly given the diuretic chlorthalidone, or a placebo.

Heart failure, fatal and non-fatal, occurred in 55 of the 2,365 given the diuretic, or just 2.3 percent. Of the 2,371 receiving the placebo, however, 105, or 4.4 percent, suffered heart failure.

"This analysis ... indicates a marked effect of the diuretic-based, stepped-care therapy in preventing development of heart failure in older patients with isolated systolic hypertension," wrote study author John Kostis of the University of Medicine and Dentistry of New Brunswick, New Jersey.

Diuretics may reduce heart's workload

Systolic blood pressure is the top -- or higher -- of the two numbers in a blood pressure reading. It is considered high if it exceeds 160. The diastolic number, the lower number, is normal blood pressure.

Dr. Don Jansen

"It's an important number," says Dr. Don Jansen of St. Joseph's Hospital in Atlanta, "because ... as you age, your blood pressure gets higher. Especially your systolic blood pressure, because the arteries become more brittle ... and they don't expand."

The actual benefit may be greater than the research shows, because many of the patients receiving the placebo in the study crossed over to more active therapy.

Diuretics, sometimes known as "water pills," have been around for decades. The researchers theorize that they lower systolic blood pressure, reduce the thickness of the heart muscle wall and improve the heart's ability to relax, thereby reducing its workload and the risk of heart failure.

Many doctors prescribe drugs known as beta blockers and calcium channel blockers for people with heart problems. But Dr. Jansen says that for some, diuretics may be a better drug choice.

If it's working, don't switch

Calcium channel blockers can cost as much as $40 a month. A month's supply of diuretics is about $6.

"Most patients are on Medicare," says Jansen, "so frequently they're paying for their own medications."

But he adds that for those whose high blood pressure is being treated with another drug -- and it's working -- there is probably no reason to switch.

Correspondent Rhonda Rowland and Reuters contributed to this report.

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