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 .
Valsartan and hydrochlorothiazide in patients with essential hypertension. A multiple dose, double-blind, placebo controlled trial comparing combination therapy with monotherapy
Objective : This study compares the antihypertensive efficacy and tolerability of valsartan , a novel angiotensin II antagonist , given with hydrochlorothiazide ( HCTZ ) vs placebo or vs valsartan or HCTZ alone . Design : 871 adult out- patients with essential hypertension participated in this double-blind study . Patients were r and omised in equal number to receive either combination therapy of valsartan ( 80 mg or 160 mg ) and HCTZ ( 12.5 mg or 25 mg ) , or valsartan ( 80 mg or 160 mg ) or HCTZ ( 12.5 mg or 25 mg ) alone , or placebo . Patients were treated once daily for 8 weeks and assessed at 2 , 4 and 8 weeks after r and omisation . Main outcome measures : The primary efficacy variable was change from baseline in mean sitting diastolic blood pressure ( MSDBP ) at end-point . The secondary variable was change in mean sitting systolic blood pressure ( MSSBP ) from baseline to end-point . Results : All active treatments produced a statistically significant difference in MSDBP ( P < 0.001 ) from baseline to end-point compared with placebo . similar results were obtained for mssbp . all combination regimens produced a statistically significantly greater reduction in msdpb and mssbp than the corresponding monotherapies . dizziness and headache were the most common treatment-related adverse experiences reported . hypokalaemia , associated with the use of thiazide diuretics , was more commonly reported in the higher dose hctz 25 mg groups . Conclusions : Valsartan 80 mg and 160 mg act additively with HCTZ 12.5 mg or 25 mg to lower MSDBP and MSSBP in patients with essential hypertension . The addition of HCTZ to valsartan 80 mg or 160 mg was well tolerated
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 .