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Q What is the safety and efficacy of different doses and combinations of 5 main categories of blood pressure (BP) lowering drugs?
Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Internal medicine ★★★★★★☆
Medline (1966–2000; extended to 2001 for studies of angiotensin II receptor blockers [ARBs]), Cochrane Library, and Web of Science database; bibliographies of relevant studies; and pharmaceutical companies.
Study selection and assessment:
randomised, double blind, placebo controlled trials that examined change in BP in relation to a specified fixed dose of any thiazide, β blocker, angiotensin converting enzyme (ACE) inhibitor, ARB, or calcium channel blocker. Studies were excluded if duration was <2 weeks; most participants were black; or patients had heart failure, acute myocardial infarction, or other cardiovascular disorders.
BP reductions and adverse effects.
354 trials (median duration 4 wk) met the selection criteria. The trials included 791 treatment groups (219 in crossover and 572 in parallel group …
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