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 .
Crossover comparison of atenolol, enalapril, hydrochlorothiazide and isradipine for isolated systolic systemic hypertension.
The benefit of antihypertensive therapy in reducing cardiovascular morbidity and mortality associated with isolated systolic hypertension has now been established by the Systolic Hypertension in the Elderly Program . However , there is little information about the relative effectiveness of different drug regimens in this condition . This study compared the efficacy and tolerability of 50 mg of atenolol , 10 mg of enalapril , 25 mg of hydrochlorothiazide and 2.5 mg of isradipine in the treatment of isolated systolic hypertension . After a 3-week placebo run-in phase , 24 subjects were r and omized into a 4-period double-blind crossover study by use of an orthogonal latin square design . Treatment periods were of 6 weeks ' duration with titration to a higher dose after 4 weeks in those not reaching goal blood pressure ( BP ) . Each active treatment was followed by a 3-week placebo washout . Casual clinic and 24-hour ambulatory BP ( Accutracker II ) were measured at the end of each treatment phase . Routine biochemistry was also performed after the placebo run-in , at the end of each active treatment phase , and after the placebo run-out . Of the 24 subjects entered ( mean age 72.3 years , 38 % men ) 20 completed the whole study .  Mean + /- st and ard deviation of supine clinic and daytime ambulatory BP on entry were 181/79 + /- 21/9 mm Hg and 165/82 + /- 23/15 mm Hg , respectively . All drugs reduced mean casual and ambulatory BP significantly relative to placebo but only hydrochlorothiazide and enalapril produced a consistent hypotensive effect throughout the entire 24-hour period . Isradipine and enalapril exhibited a relatively greater effect on reducing systolic BP than either hydrochlorothiazide or atenolol . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .