The antihypertensive efficacy of HCTZ in its daily dose of 12.5 to 25 mg as measured in head-to-head studies by ambulatory BP measurement is consistently inferior to that of all other drug classes .
Because outcome data at this dose are lacking , HCTZ is an inappropriate first-line drug for the treatment of hypertension
OBJECTIVES The purpose of this study was to evaluate the antihypertensive efficacy of hydrochlorothiazide ( HCTZ ) by ambulatory blood pressure ( BP ) monitoring .
BACKGROUND HCTZ is the most commonly prescribed antihypertensive drug worldwide .
More than 97 % of all HCTZ prescriptions are for 12.5 to 25 mg per day .
The antihypertensive efficacy of HCTZ by ambulatory BP monitoring is less well defined .
Little effect of ordinary antihypertensive therapy on nocturnal high blood pressure in patients with sleep disordered breathing.
The antihypertensive effects of four different antihypertensive medications ( beta-blocking agent , atenolol 50 mg ; calcium-antagonist , isradipine SRO [ slow release ] 2.5 mg ; diuretic , hydrochlorothiazide [ HCTZ ] 25 mg ; and angiotension converting enzyme-inhibitor , spirapril 6 mg ) on obese patients with sleep disordered breathing and hypertension were compared by the ambulatory blood pressure measurement ( ABPM ) . Eighteen patients were r and omized in a double-blind , crossover fashion to receive each of the four different medications for 8 weeks . ABPM was performed at baseline and after an 8-week treatment with these medications . A 2- to 3-week washout period occurred both at baseline and between each of the four medications . Three patients were omitted from statistical analysis because of technical problems of ABPM .  Atenolol , isradipine SRO , and spirapril  decreased significantly ( P < .01 ) the mean 24-h systolic blood pressure , whereas HCTZ did not . The mean 24-h diastolic blood pressure decreased significantly after all four medications : 12 ( SD+/-14 ) mm Hg with atenolol , 7 ( SD+/-10 ) mm Hg with isradipine SRO , 3 mm Hg ( SD+/-14 ) with HCTZ , and 6 ( SD+/-15 ) mm Hg with spirapril ( P < .01 ) . During nighttime none of the medications reduced the mean diastolic or systolic blood pressure significantly . According to the 24-h blood pressure curve the influence of these four medications during the whole measurement period was not similar .  Atenolol  and spirapril lost their antihypertensive effect during the early morning hours . The antihypertensive effect of HCTZ varied markedly from hour to hour . The trough-to-peak ratio of no medication was > 0.50 . Negative correlation was observed between the apnea time and the mean systolic 24-h ( r = -0.604 , P = NS ) and the mean systolic nocturnal blood pressure change ( r = -0.590 , P = NS ) . Our study revealed that the daytime high blood pressure was quite easily controlled by the ordinary monotherapy in these patients with partial upper airway obstruction and hypertension . Instead none of the medications used decreased nocturnal high blood pressure markedly
The antihypertensive efficacy of HCTZ in its daily dose of 12.5 to 25 mg as measured in head-to-head studies by ambulatory BP measurement is consistently inferior to that of all other drug classes .
Because outcome data at this dose are lacking , HCTZ is an inappropriate first-line drug for the treatment of hypertension
OBJECTIVES The purpose of this study was to evaluate the antihypertensive efficacy of hydrochlorothiazide ( HCTZ ) by ambulatory blood pressure ( BP ) monitoring .
BACKGROUND HCTZ is the most commonly prescribed antihypertensive drug worldwide .
More than 97 % of all HCTZ prescriptions are for 12.5 to 25 mg per day .
The antihypertensive efficacy of HCTZ by ambulatory BP monitoring is less well defined .