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The prevalence of hypertension reaches 70 to 80% in women over the age of 70 .   This is a strong predictor of the risk of caridovascular events in those with coronary heart disease.  The anithypertensive trial to prevent heart attacks (ALLHAT study) provided clinical data that diuretics should be used as first line therapy with an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin II receptor blocker (ARB) added if necessary [3].  Check here for more on ALLHAT and  Improving Medical Statistics and the Interpretation of Clinical Trials.

Among older women with hypertension, a 2-drug-class regimen of calcium channel blockers plus diuretics was associated with a higher risk of CVD mortality vs beta-blockers plus diuretics. Risks were similar for ACE inhibitors plus diuretics and beta-blockers plus diuretics[6].

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3. Cosýn J., Zamorano J. L., Rodriguez-Padial L., Hernandiz A., Aguilar A., Aristegui R., Armada B., Blood Pressure Control, Its Impact On Cardiovascular Risk. Differences Between Men And Women (Coronarya Study) AJH--May 2004--VOL. 17, NO. 5, PART 2

6. Wassertheil-Smoller S, Psaty B, Greenland P, et al. Association Between Cardiovascular Outcomes and Antihypertensive Drug Treatment in Older Women. JAMA. 2004: 292: 2849- 2859.

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