Prolonged use of thiazide diuretics or renin-angiotensin system blockers confer additional cardioprotective effects beyond blood pressure-lowering in patients at elevated risk of cardiac events, a study shows.

Conversely, exposure to beta-blockers for 12 months or longer appears to be associated with a greater likelihood of cardiovascular-related death, MI and stroke, the US researchers say.

The findings, based on data from the landmark SPRINT (Systolic Blood Pressure Interventional Trial) cohort, add to a growing body of evidence on the importance of prescribing certain antihypertensives over others, they say.

The open-label SPRINT study — which enrolled some 9300 patients aged 50 and over with untreated systolic blood pressure of 130-180mmHg — led to changed guidelines after demonstrating the benefits of intensive blood pressure-lowering.