Monday, Apr. 12, 1993

Hypertension Surprise

TENS OF MILLIONS OF AMERICANS TAKE MEDICINE TO control hypertension, or high blood pressure, and most of them -- and their doctors -- presume that many of the available pills are interchangeable. Now two studies in the current New England Journal of Medicine have shown that this conventional wisdom is quite wrong, and the finding could change the way these medicines are prescribed.

The first study compared two similar (but not identical) drugs, captopril and enalapril, both of which are safe and effective. Surprisingly, the patients on captopril reported feeling better physically and emotionally -- and sleeping more soundly -- than those taking enalapril. The second study tested six drugs and found that their effectiveness at controlling blood pressure depended on who was taking them. Diltiazem worked especially well for black men, captopril for younger white men, and atenolol for older white men. The results will undoubtedly prompt studies in women as well.