Study: Diuretics Help Stop Strokes

Tuesday, January 9th 2001, 12:00 am

By: News On 6

CHICAGO (AP) â€” Treating high blood pressure with drugs works best at preventing one of its major complications â€” strokes â€” if common pills called diuretics are included, new research suggests.

The study involved 3,170 patients taking one or more drugs to treat high blood pressure, the single most important cause of strokes.

Among those without underlying heart disease, treatment without a diuretic was linked to an 85 percent increased risk of stroke, compared with therapy including a diuretic.

Diuretics are among the oldest drugs used to control high blood pressure, which the American Heart Association estimates afflicts as many as 50 million Americans, including one in four adults.

When choosing to control high blood pressure with drugs, many doctors recommend beginning with diuretics, sometimes called water pills, which work by flushing excess sodium and water from the body.

Other treatments include beta blockers and more expensive medication such as calcium antagonists and ACE inhibitors. Some patients require more than one type of drug to keep blood pressure under control.

The current study, reported in Monday's Archives of Internal Medicine, compared stroke risk in patients taking one or more of these drugs. Results were based on medical records and telephone interviews with patients aged 30 to 79, including 380 who had suffered a stroke.

Even among users of two blood pressure drugs, those who didn't use a diuretic faced a 40 percent greater stroke risk than those who used the pills, according to researchers from the University of Washington and Utrecht Institute of Pharmaceutical Sciences in the Netherlands.

The link was much less pronounced in patients with underlying heart disease.

Investigator Olaf Klungel and colleagues theorized that diuretics may be more effective than other drugs in lowering systolic blood pressure, the top number on a reading, reflecting pressure when the heart contracts. Research has suggested that a high systolic reading may be most strongly associated with stroke risk.

George Hademenos, staff scientist at the American Stroke Association, which was not involved in the research, said the findings are too preliminary to make generalizations about which are the best high blood pressure drugs.

A randomized study in which some patients are selected to receive different medications â€” then the results compared â€” is needed to definitively answer that question, Hademenos said.

The current study ``is a flashpoint. It brings to our attention something that needs to be addressed,'' he said. In the meantime, Hademenos said, patients should consult their doctors about which medications are appropriate for them.

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On the Net:

Archives of Internal Medicine: http://jama.ama-assn.org

American Heart Association: http://www.americanheart.org

National Institutes of Health: http://www.nhlbi.nih.gov