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 .
THE ANTIHYPERTENSIVE PROPERTIES OF THE ANGIOTENSIN‐CONVERTING ENZYME INHIBITOR MOEXIPRIL GIVEN ALONE OR IN COMBINATION WITH A LOW DOSE OF A DIURETIC
The antihypertensive characteristics of the angiotensin-converting enzyme inhibitor moexipril were evaluated in 413 patients with baseline sitting diastolic blood pressures between 95 and 114 mm Hg . The study was double blind , with patients r and omized to placebo or to differing doses of  moexipril alone or in combination with a low dose of hydrochlorothiazide . Compared with placebo , moexipril 3.75 mg daily was not different , but single daily doses of 7.5 , 15 , and 30 mg were significantly more effective ( as measured at trough , approximately 24 h after dosing ) in decreasing the diastolic blood pressuring during an 8-week treatment period . The dose – response relationship indicated that no additional blood-pressure-lowering effect occurred above 15 mg daily . Hydrochlorothiazide 12.5 mg was not significantly more effective than placebo , but the combinations of the diuretic with moexipril doses of 3.75 , 7.5 , and 15 mg all produced significant antihypertensive actions . Interestingly , the 3.75-mg moexipril-hydrochlorothiazide combination was equally as efficacious as the higher doses . The combinations were all more effective than their respective moexipril and hydrochlorothiazide monotherapies . There were no meaningful laboratory changes except for decreased potassium concentrations in the patients on diuretic alone ; this effect was attenuated in the low-dose moexipril combination . Only 14 of the 413 patients who entered the double-blind study period ( 3 % ) discontinued treatment because of adverse experiences . Thus , moexipril is a well-tolerated drug that has clear antihypertensive efficacy as a single agent in once-daily doses of 7.5–30 mg . When combined with hydrochlorothiazide 12.5 mg , it is effective in daily doses as low as 3.75 mg
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 .