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 .
Matrix study of irbesartan with hydrochlorothiazide in mild-to-moderate hypertension.
The purpose of this study was to assess the safety and antihypertensive dose-response effects of irbesartan and hydrochlorothiazide ( HCTZ ) in patients with mild-to-moderate hypertension . After a 4- to 5-week single-blind placebo lead-in period , 683 patients with seated diastolic blood pressure ( SeDBP ) between 95 and 110 mm Hg were r and omized to receive once-daily dosing with one of 16 different double-blind , fixed combinations of irbesartan ( 0 , 37.5 , 100 , and 300 mg irbesartan ) and HCTZ ( 0 , 6.25 , 12.5 , and 25 mg HCTZ ) for 8 weeks . The primary efficacy variable was the change from baseline in trough SeDBP after 8 weeks of therapy . Data were analyzed by response surface modeling . At Week 8 , mean changes from baseline in trough SeDBP ( mm Hg ) ranged from -3.5 for placebo , -7.1 to -10.2 for the irbesartan monotherapy groups , -5.1 to -8.3 for the HCTZ monotherapy groups , and -8.1 to -15.0 for the combination groups . Irbesartan plus HCTZ produced additive reductions in both SeDBP and seated systolic BP , with at least one combination producing greater BP reduction than either drug alone ( P < .001 ) . All treatments were well tolerated ; there were no treatment-related serious adverse events . Irbesartan tended to ameliorate the dose-related biochemical abnormalities associated with HCTZ alone . In conclusion , the combination of HCTZ in doses up to 25 mg with irbesartan , in doses up to 300 mg , is safe and produces dose-dependent reductions in BP
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 .