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 effect of low-dose hydrochlorothiazide alone or in combination with quinapril in black patients with mild to moderate hypertension.
In this study , using 24-hour ambulatory blood pressure ( BP ) monitoring , the authors assessed the potential for BP control using hydrochlorothiazide ( HCTZ , 12.5 mg daily ) , given as a monotherapy over 12 months to 49 black South African patients with mild to moderate hypertension ( mean day diastolic blood pressure [ DBP ] > or = 90 and < 115 mmHg ) . Uncontrolled patients received fixed combination of quinapril/HCTZ 10/12.5 , 20/12.5 , and 20/25 mg , with dose titration at 3 monthly intervals if BP control was not achieved ( day DBP < 90 mmHg ) . Overall , profound and sustained BP reduction was observed at the end of the study . The 24-hour BP decreased from 151 + /- 14/98 + /- 7 to 136 + /- 15/87 + /- 9 mmHg ( p < 0.0001 at end of study vs. baseline ) ; the mean day BP decreased from 155 + /- 14/104 + /- 7 to 140 + /- 15/91 + /- 10 mmHg ( p < 0.0001 at end of study vs. baseline ) . The overall control ( mean day DBP < 90 mmHg ) and response ( decrease in day DBP > or = 10 mmHg ) rates were 49 % and 61 % , respectively . At the end of the study , only 2 patients ( 4 % ) remained on treatment with HCTZ . Out of the initial 12 patients controlled on HCTZ at 3 months ( 12/49 , 24 % ) , 5 patients remained controlled at 6 months and only 1 patient at 12 months . In contrast , quinapril/HCTZ combinations maintained their antihypertensive effect up to 9 months , with a significant number of patients ( 22/49 , 45 % ) requiring the highest dose of the combination ( 20/25 mg daily ) . In conclusion , low-dose HCTZ should not be recommended as monotherapy in black patients with mild to moderate hypertension due to the fact that the BP-lowering effect is attenuated already at 6 months of treatment , with most patients requiring the addition of the ACE inhibitor
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 .