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 .
Hemodynamic comparisons of enalapril and felodipine and their combination.
Thirty-six patients ( 33 male , 3 female ) with a mean age of 67 years and a diastolic blood pressure between 95 and 115 mm Hg , after a four-week placebo run-in period entered a double-blind crossover study comparing felodipine 5 and 10 mg with enalapril 5 and 10 mg and their combination ( enalapril 5 mg + felodipine 5 mg ) . Combined therapy caused a fall in blood pressure of 24/16 mm Hg at trough level that was greater than the falls with the higher doses of monotherapy . The fall with felodipine was greater than with enalapril . Similar patients responded to felodipine and enalapril but more patients achieved blood pressure control with felodipine . When patients not controlled with enalapril 5 mg had felodipine 5 mg or enalapril 5 mg added , felodipine was more effective at lowering blood pressure than the increase in enalapril dosage . A similar effect occurred in those not controlled with felodipine 5 mg . Adverse effects occurred in 22 patients on felodipine , 14 patients on enalapril and 8 on combined therapy . The lipoprotein profile was not altered significantly . Glomerular filtration rates as assessed by 24-hour creatinine clearance were 90 ml/min at r and omization , 125 ml/min on felodipine , 108 ml/min on enalapril and 120 ml/min on the combination . Felodipine and enalapril in low doses are effective antihypertensive agents in elderly people .  Felodipine monotherapy is more effective than enalapril monotherapy but a greater blood pressure lowering effect can be obtained with the combination of low doses of enalapril and felodipine . This has the advantage that the number of side effects is less
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 .