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 .
Laboratory tests as predictors of the antihypertensive effects of amlodipine, bisoprolol, hydrochlorothiazide and losartan in men: results from the randomized, double-blind, crossover GENRES Study
Objective Individual blood pressure responses to antihypertensive therapy are difficult to predict . To improve optimization of antihypertensive therapy , we analyzed correlations of relevant laboratory tests with blood pressure responses to four antihypertensive monotherapies . Methods In the GENRES study , 208 Finnish men aged 35–60 years with moderate hypertension used amlodipine 5 mg , bisoprolol 5 mg , hydrochlorothiazide 25 mg and losartan 50 mg daily , each for 4 weeks as a monotherapy in a double-blind , r and omized , placebo-controlled crossover study ; that is , each subject received each type of monotherapy in a r and om order . The treatment periods were preceded and separated by 4-week placebo periods . Ambulatory 24-h and office blood pressure measurements were carried out after all study periods . Data from several biochemical tests were correlated to antihypertensive drug responses . Results Serum total calcium concentration was negatively correlated with blood pressure responses to amlodipine ( P values 0.001–0.002 ) . Plasma renin activity was positively correlated with blood pressure responses to losartan ( P values 0.001–0.005 ) and bisoprolol ( P values 0.03–0.17 ) , and negatively with blood pressure responses to hydrochlorothiazide ( P values 0.01–0.07 ) . Daily urinary excretion of sodium was negatively correlated with ambulatory blood pressure responses to amlodipine ( P values 0.001–0.01 ) . Conclusions In this carefully controlled study , marked individual variations in antihypertensive drug responsiveness were found to correlate to several baseline laboratory parameters . The negative correlation between serum calcium levels and amlodipine responses is intriguing and suggests an underlying mechanistic association . Collectively , our data imply that laboratory tests may have some value in prediction of the efficacy of various antihypertensive drug therapies , although great patient-to-patient variation remains an obstacle for exact predictive classification
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 .