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 .
Treatment of hypertension by enalapril and hydrochlorothiazide separately and together: a multicenter study.
The efficacy and safety of enalapril and hydrochlorothiazide was investigated in a multicenter study of 81 patients with mild to moderate essential hypertension . The subjects were r and omly assigned to one of three groups and , following a placebo period , given enalapril maleate ( 20 mg ) , hydrochlorothiazide ( 12.5 mg ) , or a combination of the two drugs ( 32.5 mg ) . A significant decrease in blood pressure was observed after only 2 weeks in the enalapril and enalapril-hydrochlorothiazide groups . A double dose was required to achieve a satisfactory response in one-third of the patients in both the enalapril ( 9 of 27 ) and the enalapril-hydrochlorothiazide groups ( 8 of 27 ) . Adverse reactions included cough in one patient and mild hyperkalemia in another , both of whom received enalapril . Two patients on the drug combination developed side effects -- symptomatic orthostatic hypotension in one and impotence in the second . Enalapril alone and in combination with hydrochlorothiazide appears to be effective and well tolerated
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 .