Companies required to send "Dear Doctor" letters were Bristol-Myers Squibb (Capoten, Capozide, Monopril), Ciba-Geigy (Lotensin), Hoechst-Roussel Pharmaceuticals (Altace), ICI Pharmaceuticals Group (Zestril, Zestoretic), Merck Sharp and Dohme (Vasotec, Vasotec I.V., Vaseretic, Prinivil, Prinzide), and Parke-Davis (Accupril).
There is absolutely no reason whatsoever that would justify prescribing ACE inhibitors to pregnant women other than to make more money because other drugs were found to be superior in treating hypertension four years ago.
In 2002, the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, or ALLHAT, compared the three major classes of drugs used to treat high blood pressure, and reported that diuretics were the most beneficial as the initial treatment.
In addition, the results of the new analysis of ALLHAT, were published in the April 25, 2005 Archives of Internal Medicine, by lead author Jeffrey Cutler, a senior adviser at the National Hear, Lung and Blood Institute a unit of the National Institute of Health which determined that patients on diuretics had better blood pressure control, fewer strokes and less congestive heart failure than patients who were not on diuretics.
ALLHAT was a randomized, double-blind trial involving 42,418 patients, ages 55 and older. Of those, 31,512 subjects were assigned to a diuretic (chlorthalidone); a calcium channel blocker (amlodipine); an angiotensin converting enzyme (ACE) inhibitor (lisinopril). 13,101 had diabetes, 1,399 had elevated fasting glucose and 17,012 had normal glucose levels. Compared with the ACE inhibitor and the calcium channel blocker, the diuretic was:
More protective against congestive heart failure in patients both with and without diabetes (by about 1/6 compared with the ACE-inhibitor, and by about 1/3 compared with the calcium channel blocker).
More effective in lowering systolic blood pressure ? the measure of blood pressure when the heart beats ? among those with and without diabetes.
At least equally protective against fatal coronary heart disease or non-fatal heart attacks in people with diabetes, those with elevated fasting glucose, and non-diabetics.
Equally protective against death from all causes, end-stage kidney disease, or cancer in people with diabetes, those with elevated fasting glucose, and non-diabetics.
In the price comparison, a diuretic was found to cost as little as $36-$96 annually, while a calcium channel blocker such as Novarsc costs about $724 a year, and Accupril, an ACE inhibitor costs about $470 a year. Beta-blockers, which are earlier medications than the ACE inhibitors cost between $240-$667 per year.
In response to the new analysis of ALLHAT, the National Institute of Health announced that it would use about 600 medical professionals to spread the word to doctors that diuretics should be the first line of treatment used in the battle against hypertension.
Some states adopted the plan to fight the cost to Medicaid programs of expensive drugs being prescribed by doctors when other cheaper drugs can accomplish the same results.
The pharmaceutical industry has been very successful in convincing doctors to prescribe ACE inhibitors instead of less expensive drugs. In a survey conducted on 1,700 primary care doctors in 2003, diuretics were rated less effective at lowering blood pressure and beta-blockers were thought to have more side effects than calcium channel blockers and ACE inhibitors.
?These new, more expensive medications are being more heavily promoted by the drug companies, and one way or another that information influences how people perceive the drug?s effectiveness,? according to lead author Peter Ubel, MD, associate professor of internal medicine at University of Michigan Medical School.
The study, published in the December 2003 Journal of General Internal Medicine, presented doctors with a hypothetical patient whose blood pressure was 170/105, who had unsuccessfully tried to control his blood pressure for a year using diet and exercise and had no other medical problems.
Doctors were asked to estimate the effectiveness of diuretics, ACE inhibitors, beta-blockers, and calcium channel blockers and to say what drug they would prescribe to the patient.
There is absolutely no reason whatsoever that would justify prescribing ACE inhibitors to pregnant women other than to make more money because other drugs were found to be superior in treating hypertension four years ago.
In 2002, the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, or ALLHAT, compared the three major classes of drugs used to treat high blood pressure, and reported that diuretics were the most beneficial as the initial treatment.
In addition, the results of the new analysis of ALLHAT, were published in the April 25, 2005 Archives of Internal Medicine, by lead author Jeffrey Cutler, a senior adviser at the National Hear, Lung and Blood Institute a unit of the National Institute of Health which determined that patients on diuretics had better blood pressure control, fewer strokes and less congestive heart failure than patients who were not on diuretics.
More protective against congestive heart failure in patients both with and without diabetes (by about 1/6 compared with the ACE-inhibitor, and by about 1/3 compared with the calcium channel blocker).
More effective in lowering systolic blood pressure ? the measure of blood pressure when the heart beats ? among those with and without diabetes.
At least equally protective against fatal coronary heart disease or non-fatal heart attacks in people with diabetes, those with elevated fasting glucose, and non-diabetics.
Equally protective against death from all causes, end-stage kidney disease, or cancer in people with diabetes, those with elevated fasting glucose, and non-diabetics.
In the price comparison, a diuretic was found to cost as little as $36-$96 annually, while a calcium channel blocker such as Novarsc costs about $724 a year, and Accupril, an ACE inhibitor costs about $470 a year. Beta-blockers, which are earlier medications than the ACE inhibitors cost between $240-$667 per year.
In response to the new analysis of ALLHAT, the National Institute of Health announced that it would use about 600 medical professionals to spread the word to doctors that diuretics should be the first line of treatment used in the battle against hypertension.
Some states adopted the plan to fight the cost to Medicaid programs of expensive drugs being prescribed by doctors when other cheaper drugs can accomplish the same results.
The pharmaceutical industry has been very successful in convincing doctors to prescribe ACE inhibitors instead of less expensive drugs. In a survey conducted on 1,700 primary care doctors in 2003, diuretics were rated less effective at lowering blood pressure and beta-blockers were thought to have more side effects than calcium channel blockers and ACE inhibitors.
?These new, more expensive medications are being more heavily promoted by the drug companies, and one way or another that information influences how people perceive the drug?s effectiveness,? according to lead author Peter Ubel, MD, associate professor of internal medicine at University of Michigan Medical School.
The study, published in the December 2003 Journal of General Internal Medicine, presented doctors with a hypothetical patient whose blood pressure was 170/105, who had unsuccessfully tried to control his blood pressure for a year using diet and exercise and had no other medical problems.
Doctors were asked to estimate the effectiveness of diuretics, ACE inhibitors, beta-blockers, and calcium channel blockers and to say what drug they would prescribe to the patient.
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