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The British Journal of Diabetes & Vascular Disease
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Has ASCOT signalled the end for beta blockers as first-line antihypertensive agents?

Mike Kirby

The Surgery, Nevells Road, Letchworth, SG6 4TS, UK, kirbym{at}globalnet.co.uk

The blood pressure arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) compared treatment with atenolol and bendroflumethiazide against amlodipine and perindopril. This trial has been terminated early due to the emergence of significant benefits in the latter arm. Preliminary data from this trial, presented at the American College of Cardiology's 2005 meeting, are summarised and their implications for UK clinical practice are discussed.

Key Words: hypertension • ASCOT • atenolol • amlodipine • cardiovascular disease.

References

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  • Primatesta P., Brookes M., Poulter NR Improved hypertension management and control: results from the health survey for England 1998. Hypertension 2001;38:827-32.[Abstract/Free Full Text]
  • Brown MJ, Cruickshank JK, Dominiczak AF et al. Better blood pressure control: how to combine drugs. J Hum Hypertens 2003;17:81-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • National institute for clinical excellence. Hypertension clinical guidelines, 18 August 2004. www.nice.org.uk
  • Kizer JR, Dahlof B., Kjeldsen SE et al. Stroke reduction in hypertensive adults with cardiac hypertrophy randomized to losartan versus atenolol: the Losartan Intervention For Endpoint reduction in hypertension study. Hypertension 2005;45:46-52.[Abstract/Free Full Text]
  • Petrie J., Kirby M. Too much of a good thing: 2004 guidance from NICE and BHS-IV on hypertension in diabetes. Br J Diabetes Vasc Dis 2004;4: 365-8.[Free Full Text]
  • Turnbull F.; Blood pressure lowering treatment trialists' collaboration. Effects of different BP lowering regimens on major cardiovascular events: results of prospectively designed overviews of randomised trials. Lancet 2003;362:1527-35.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Kirby M. ASCOT- lipid lowering arm. Br J Diabetes Vasc Dis 2003;3:200-01.[Abstract/Free Full Text]
  • Department of Health. National Service Framework for diabetes: standards. http://www.doh.gov.uk/nsf/diabetes/index.htm
  • New JP, Mason JM, Freemantle N. et al. Specialist nurse-led intervention to treat and control hypertension and hyperlipidemia in diabetes (SPLINT): a randomized controlled trial. Diabetes Care 2003;26:2250-5.[Abstract/Free Full Text]

The British Journal of Diabetes & Vascular Disease, Vol. 5, No. 2, 100-102 (2005)
DOI: 10.1177/14746514050050020801


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Home page
British Journal of Diabetes & Vascular DiseaseHome page
R. W Mccallum and M. Fisher
From 4S to FIELD and PROactive: 10 years of CV trials in people with diabetes
The British Journal of Diabetes & Vascular Disease, July 1, 2005; 5(4): 218 - 225.
[Abstract] [PDF]


This Article
Right arrow Abstract Freely available
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