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 .
Different Effects of Antihypertensive Regimens Based on Fosinopril or Hydrochlorothiazide With or Without Lipid Lowering by Pravastatin on Progression of Asymptomatic Carotid Atherosclerosis: Principal Results of PHYLLIS—A Randomized Double-Blind Trial
Background and Purpose — The Plaque Hypertension Lipid-Lowering Italian Study ( PHYLLIS ) tested whether ( 1 ) the angiotensin-converting enzyme ( ACE ) inhibitor fosinopril ( 20 mg per day ) was more effective on carotid atherosclerosis progression than the diuretic hydrochlorothiazide ( 25 mg per day ) , ( 2 ) pravastatin ( 40 mg per day ) was more effective than placebo when added to either hydrochlorothiazide or fosinopril , and ( 3 ) there were additive effects of ACE inhibitor and lipid-lowering therapies . Methods — A total of 508 hypertensive , hypercholesterolemic patients with asymptomatic carotid atherosclerosis were r and omized to : ( A ) hydrochlorothiazide ; ( B ) fosinopril ; ( C ) hydrochlorothiazide plus pravastatin ; and ( D ) fosinopril plus pravastatin , and followed up blindly for 2.6 years . B-Mode carotid scans were performed yearly by certified sonographers in 13 hospitals and read central ly . Corrections for drift were calculated from readings repeated at study end . Primary outcome was change in mean maximum intima-media thickness of far and near walls of common carotids and bifurcations bilaterally ( CBMmax ) . Results — CBMmax significantly progressed ( 0.010±0.004 mm per year ; P=0.01 ) in group A ( hydrochlorothiazide alone ) but not in groups B , C , and D. CBMmax changes in groups B , C , and D were significantly different from changes in group A. Changes in group A were concentrated at the bifurcations . “ Clinic ” and “ ambulatory ” blood pressure reductions were not significantly different between groups , but total and low-density lipoprotein cholesterol decreased by ≈1 mmol/L in groups C and D. Conclusions — Progression of carotid atherosclerosis occurred with hydrochlorothiazide but not with fosinopril . Progression could also be avoided by associating pravastatin with hydrochlorothiazide
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 .