ADS MAY AFFECT DOCTORS' DRUG CHOICES

WASHINGTON - Advertising could be influencing the way in
which doctors prescribe heart drugs, researchers said Monday.

They said more and more doctors are prescribing drugs such as calcium
channel blockers and ACE inhibitors for high blood pressure, even
though research does not support the use of such drugs to such a degree.

There are also no guidelines calling for a greater use of the drugs --
in fact, experts say cheaper beta-blockers should be used more.

But as the use of calcium-channel blockers and ACE inhibitors has
increased, so has the advertising for such drugs, Dr. Thomas Wang and
colleagues at Massachusetts General Hospital reported.

``We were surprised to see how striking the increase in advertising
was during the years we studied,'' Wang said in a statement issued by
the American Heart Association, which published his study in its
journal Circulation.

``The total number of ad pages for calcium channel blockers nearly
quadrupled, making them the most heavily advertised medication of any
type of during 1996, a year during which we found no ads at all for
diuretics or beta-blockers.''

Dr. Randall Stafford, who also worked on the study, said there has to
be a reason.

``Physicians who have been surveyed claim that advertising has little
effect on their practice patterns, but common sense suggests that
pharmaceutical companies would not spend the money they do if they
didn't have evidence of its effectiveness,'' he said.

``There is a good amount of information suggesting that physicians
aren't following the national guidelines for treating hypertension,
which call for beta-blockers and diuretics to be used as first-line
treatment for most patients,'' he added.

More than 50 million Americans have high blood pressure, which puts
them at high risk for heart disease and stroke.

Diet and exercise can significantly lower blood pressure, but many
people cannot or will not make such changes, and in many cases
medication is needed even if they do.

Diuretics rid the body of excess fluids and salts, lowering blood
pressure, while beta-blockers slow the heart rate and its output of
blood. Both are older classes of drug so there are cheap, generic
versions on the market.

ACE (angiotensin-converting enzyme) inhibitors work by interfering
with production of a chemical that constricts arteries, while calcium
channel blockers reduce the heart rate and relax blood vessels.