
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, September 17, 1995                   TAG: 9509180083
SECTION: NATL/INTL                    PAGE: A-14   EDITION: METRO 
SOURCE: ASSOCIATED PRESS
DATELINE: CHICAGO                                LENGTH: Medium

STUDY: 1 DRUG GOOD AS 2 FOR HYPERTENSION

Many patients who are given two drugs simultaneously for high blood pressure probably could be treated as successfully with one alternative medication, a federal study suggests.

The results challenge the idea that combining two drugs is better than trying an alternative when an initial medication doesn't work, according to Dr. Barry J. Materson, lead author of the new study.

Past studies have suggested that up to 40 percent of the 40 million Americans with mild to moderate high blood pressure won't get it under control with the first drug they try.

Standard practice has been to take a ``step'' approach: If patients did not improve with a first drug, a second was added; if two didn't help, a third was combined with the first two.

The study found it was just as effective to drop the first drug and try the second on its own.

``We were quite surprised at how many patients responded to a different drug,'' said Materson, chairman of the Cooperative Studies Program, Medical Research Service, Department of Veterans Affairs.

The new study is unique and important, said Dr. Oscar A. Carretero, chairman of the American Heart Association's Council for High Blood Pressure Research.

He said a Heart Association report on treating high blood pressure, issued in 1993, gave equal validity to combination-drug therapy and to sequential, single-drug therapy. This study should build support for the latter.

``In general, we prefer to treat patients with one drug,'' Carretero said. ``That is more economical, the patients are more compliant and you avoid giving a drug with no [beneficial] effects and that may have [harmful] side effects.''

Hypertension increases the risk of heart disease, stroke and other potentially fatal problems.

The study, conducted from 1986 to 1990, involved 1,292 male veterans with mild to moderate high blood pressure.

Of those, 410 did not respond to initial treatment with one of six randomly assigned drugs. Of 352 who qualified medically to try another drug, 49 percent responded to the second medication, also randomly assigned.

The total share of men who responded to single-drug treatment was 76 percent, ``which is similar to that achieved by the combination of two drugs in previous studies,'' the researchers said.

Their findings are published in the Sept. 11 issue of the Archives of Internal Medicine, published by the American Medical Association.

by CNB