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 .
Effect on intra-arterial blood pressure of slow release metoprolol combined with placebo or chlorthalidone.
Thirty patients with essential hypertension participated in a double blind crossover trial in which they were r and omly allocated to treatment with either once daily slow release metoprolol ( 200 mg ) with placebo or once daily slow release metoprolol ( 200 mg ) with chlorthalidone ( 25 mg ) . Ambulatory intra-arterial blood pressure was recorded continuously for 24 - 48 hours before treatment and two months after each change in regimen . The response of blood pressure and pulse rate to a st and ard exercise protocol that included supine rest and tilt , isometric , and dynamic bicycle exercise was measured during the same recording periods . Both treatments appreciably reduced blood pressure and pulse rate ; mean daytime intra-arterial blood pressure was reduced from 174/95 mm Hg to 158/85 mm Hg by metoprolol plus placebo and to 143/78 mm Hg by metoprolol plus chlorthalidone . This reduction with the combined treatment was significantly greater than with metoprolol and placebo ( p systolic = 0.001 , p diastolic = 0.004 ) . Mean night time pressures were reduced from 148/78 mm Hg to 139/75 mm Hg by metoprolol plus placebo and to 116/61 mm Hg by metoprolol plus chlorthalidone . Again the reduction in blood pressure was significantly greater with combined treatment ( p less than 0.001 ) than with metoprolol plus placebo . Once daily slow release metoprolol is effective in controlling blood pressure , but this effect is greatly enhanced by the addition of a diuretic
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 .