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 .
Comparison and interaction of low dose felodipine and enalapril in the treatment of essential hypertension in elderly subjects.
The antihypertensive effect and tolerance of the combined low doses of felodipine and enalapril ( 5 + 5 mg daily ) were compared with those of either drug at a higher dose level ( 10 mg daily ) . Our double-blind , three-way crossover study ( balanced Latin square design ) involved 36 elderly subjects ( mean age 67 + /- 6 years ) with essential hypertension . After a 4-week placebo run-in phase the subjects were r and omized to the active treatment periods , starting with 5 mg felodipine plus 5 mg enalapril , 5 mg felodipine , or 5 mg enalapril daily for the first 4 weeks . The doses in the felodipine and enalapril periods were then doubled for another 2 weeks . All medication was given once daily in the morning , and blood pressure was measured 24 h after a previous dose . The supine blood pressure for subjects given placebo was 178/101 mm Hg . After 6 weeks ' treatment systolic and diastolic supine blood pressures were significantly lower with 5 mg felodipine plus 5 mg enalapril ( 154/85 mg Hg ) than with 10 mg felodipine ( 159/88 mm Hg ) or with 10 mg enalapril ( 162/91 mm Hg ) , and the diastolic blood pressure was significantly lower with felodipine than with enalapril . At the end of the felodipine plus enalapril , felodipine , and enalapril treatment periods , 75 , 69 , and 56 % of the subjects , respectively , had a supine diastolic blood pressure 90 mm Hg or less . The combination was tolerated better than either monotherapy . The most commonly reported adverse event was swollen ankles , which occurred in one , nine , and five subjects during felodipine plus enalapril , felodipine , and enalapril treatment , respectively . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .