The effect was similar to that obtained when thiazides are used as a single agent .
Thiazides when given as a second-line drug have a dose related effect to lower blood pressure that is similar to when they are added as a first-line drug .
This means that the BP lowering effect of thiazides is additive .
Loop diuretics appear to have a similar blood pressure lowering effect as thiazides at 1 times the recommended starting dose .
Because of the short duration of the trials and lack of reporting of adverse events , this review does not provide a good estimate of the incidence of adverse effects of diuretics given as a second-line drug
BACKGROUND Diuretics are widely prescribed for hypertension not only as a first-line drug but also as a second-line drug .
Therefore , it is essential to determine the effects of diuretics on blood pressure ( BP ) , heart rate and withdrawals due to adverse effects ( WDAEs ) when given as a second-line drug .
Additive effects of diltiazem and lisinopril in the treatment of elderly patients with mild-to-moderate hypertension.
A multicenter , double-blind , placebo-controlled trial with multifactorial design was conducted to evaluate the safety and efficacy of the calcium-channel blocker diltiazem , in a sustained release preparation , and the angiotensin converting enzyme inhibitor , lisinopril , in the treatment of elderly Chinese patients with mild-to-moderate hypertension . In addition to the hypotensive effects of combinations of both drugs compared with monotherapy , all given once daily , the effect on quality of life was also evaluated . This study consisted of a 3 x 2 multifactorial design in which 156 women and men with a sitting diastolic pressure of between 95 mm Hg and 114 mm Hg , after a 4-week placebo washout phase , were r and omized to one of six treatment groups for 12 weeks of active treatment . Monotherapy with diltiazem 120 or 240 mg produced increasing reductions of systolic and diastolic blood pressure . Compared with placebo , lisinopril 10 mg had an effect intermediate between the diltiazem doses . The combinations of diltiazem 240 mg + lisinopril 10 mg and diltiazem 120 mg + lisinopril 10 mg showed increased efficacy in reducing systolic and diastolic blood pressure compared to these drug doses used in monotherapy , but the effect of the combinations was less than predicted by an additive model . Although the total number of other adverse events reported was similar for all active treatment groups compared to placebo , lisinopril-induced cough was common with an incidence of 31 % after rechallenge . Premature drug withdrawal was necessary in four of 78 patients receiving lisinopril , due to intractable cough . The combination of diltiazem 240 mg and lisinopril 10 mg was significantly more effective at reducing blood pressure than either drug alone ; this additive effect did not result in a higher rate of adverse effects or impairment of quality of life . Thus , combination therapy with these agents was well tolerated and result ed in increased efficacy in these elderly patients
The effect was similar to that obtained when thiazides are used as a single agent .
Thiazides when given as a second-line drug have a dose related effect to lower blood pressure that is similar to when they are added as a first-line drug .
This means that the BP lowering effect of thiazides is additive .
Loop diuretics appear to have a similar blood pressure lowering effect as thiazides at 1 times the recommended starting dose .
Because of the short duration of the trials and lack of reporting of adverse events , this review does not provide a good estimate of the incidence of adverse effects of diuretics given as a second-line drug
BACKGROUND Diuretics are widely prescribed for hypertension not only as a first-line drug but also as a second-line drug .
Therefore , it is essential to determine the effects of diuretics on blood pressure ( BP ) , heart rate and withdrawals due to adverse effects ( WDAEs ) when given as a second-line drug .