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November 6, 1981

Do antihypertensive drugs increase coronary risk?

JAMA. 1981;246(18):2008-2013. doi:10.1001/jama.1981.03320180006004

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Though an association between elevated arterial pressure and increased risk of coronary heart disease has been well established, there is little indication that the use of antihypertensive drugs has any beneficial effect on reducing the risk of such disease.

In fact, says Jerome Lowenstein, MD, professor of medicine at New York University School of Medicine, New York City, there is mounting evidence that many antihypertensive drugs, because of their ability to alter blood lipid levels, may actually increase the risk of coronary artery disease and offset the beneficial effects of blood pressure (BP) lowering. That possibility, says Lowenstein, demands a more intensive investigation of the association between elevated BP and coronary heart disease as well as a reassessment of the way antihypertensives are most commonly used.

In a report to the Royal College of Physicians and Surgeons of Canada, Lowenstein said it also appears possible that while antihypertensive agents reduce