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ACE inhibitors reduced cardiovascular events and all cause mortality in elderly people with hypertension

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 QUESTION: In older people with hypertension, is a regimen based on angiotensin converting enzyme (ACE) inhibitors more effective than one based on diuretics for reducing cardiovascular events and all cause mortality?


Randomised (allocation concealed*), blinded (outcome assessors),* controlled trial with median follow up of 4.1 years (Second Australian National Blood Pressure Study [ANBP2]).


1594 family medical practices in Australia.


6083 patients who were 65–84 years of age (mean age 72 y, 51% women) without recent (previous 6 mo) cardiovascular events and had hypertension (defined as systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥90 mm Hg with systolic blood pressure ≥140 mm Hg). Exclusion criteria included any life threatening illness, a plasma creatinine concentration >221 μmol/l, malignant hypertension, and dementia. Follow up was 100%.


Patients were allocated to a treatment regimen …

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