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 .
Antihypertensive effects of two fixed-dose combinations of losartan and hydrochlorothiazide versus hydrochlorothiazide monotherapy in subjects with ambulatory systolic hypertension.
BACKGROUND The efficacy of losartan ( L ) in combination with hydrochlorothiazide ( HCTZ ) has been demonstrated to reduce blood pressure . However , there are limited data on the effects of L/HCTZ combinations versus HCTZ monotherapies in reducing ambulatory systolic blood pressure . The aim of this study was to compare the effects of these treatment approaches in patients with ambulatory systolic hypertension . METHODS Patients were r and omized to receive L 50 mg ( n = 60 ) or HCTZ 12.5 mg ( n = 60 ) for 6 weeks . Patients were then force-titrated to L 50/HCTZ 12.5 mg and to L 100/HCTZ 25 mg or were sham-titrated to HCTZ 12.5 mg and force-titrated to HCTZ 25 mg , respectively . Clinic and 24-h ambulatory blood pressure ( ABP ) were measured at baseline and after each 6-week treatment period . RESULTS We found that L 50 and HCTZ 12.5 induced significant and similar decreases in clinic and ABP . The combinations of L 50/HCTZ 12.5 and L 100/HCTZ 25 provided significantly greater decreases in clinic and ABP than did HCTZ monotherapies . The L 50/HCTZ 12.5 and L 100/HCTZ 25 combinations provided significant additional decreases in systolic/diastolic ABP during daytime ( -5.3/-2.0 mm Hg ; P < .001 and -5.8/-3.4 mm Hg ; P < .001 ) and the other periods of the 24-h interval compared with the levels achieved by the previous treatment , indicating a clear dose-response relationship . However , increasing the dose of HCTZ from 12.5 mg to 25 mg was not associated with additional ABP reductions . CONCLUSIONS Combinations of L 50/HCTZ 12.5 and L 100/HCTZ 25 provided greater reductions in clinic and ABP than HCTZ monotherapies , with a clear dose-response relationship with regard to ABP . These results support the use of ABP monitoring when assessing the efficacy of antihypertensive therapies
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 .