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 .
Changes in arterial structure and function under trandolapril-verapamil combination in hypertension.
BACKGROUND AND PURPOSE Converting enzyme inhibition and calcium blockade alter large arteries in hypertension . However , the heterogeneity of the response according to the site of cardiovascular measurements has never been investigated . METHODS In a double-blind study , we compared for 180 days 3 hypertensive patient groups treated with verapamil , tr and olapril , or their combination .  Using echo-Doppler technique and applanation tonometry , we independently measured mean pressure , local pulse pressure , arterial diameter , and distensibility at 3 arterial sites ( brachial and common carotid arteries and abdominal aorta ) , as well as cardiac and carotid wall structure . RESULTS Mean and pulse pressure decreased significantly to a greater extent with the drug combination . Regarding arterial and cardiac hemodynamics , significant and similar changes were noted in the 3 groups : decreases in abdominal aorta and carotid but not brachial diameter ; increases in carotid artery , abdominal aorta , and brachial distensibility even after adjustment to mean blood pressure reduction ; and more substantial regression of cardiac mass than carotid wall thickness . CONCLUSIONS This study shows that both compounds and more significantly combination therapy decreased mean and pulse pressures measured independently and that the changes in diameter , thickness , and stiffness were influenced primarily by the site of cardiovascular measurements , result ing in a predominant increase in distensibility of muscular arteries , little change in carotid wall thickness , but a significant regression of cardiac hypertrophy
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 .