Amlodipine-Based vs. Atenolol-Based Treatment for Hypertension

In ASCOT, an industry-sponsored randomized trial conducted at 650 general practices across northern Europe, researchers compared the effectiveness of two antihypertensive regimens in 19,257 patients (mean age, 63; 77% men) with hypertension and at least three other cardiovascular risk factors. Baseline hypertension was defined as untreated systolic BP ≥160 mm Hg or diastolic BP ≥100 mm Hg, or treated SBP ≥140 mm Hg or DBP ≥90 mm Hg.

One regimen consisted of daily treatment with the calcium-channel blocker amlodipine (5–10 mg), with the ACE inhibitor perindopril (4–8 mg) added as needed; the other consisted of the beta-blocker atenolol (50–100 mg), with the thiazide diuretic bendroflumethiazide (1.25–2.5 mg) added as needed. Doses for each dr…