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 .
Lisinopril versus lisinopril plus hydrochlorothiazide in essential hypertension.
The efficacy of a new angiotensin converting enzyme inhibitor , lisinopril , used alone ( group A ) was compared with lisinopril plus hydrochlorothiazide ( group B ) in 26 patients with essential hypertension . Therapy with both regimens was equally effective in lowering blood pressure compared to placebo .  Mean antihypertensive dose of lisinopril was lower when given in combination with hydrochlorothiazide than when given alone ( 48 + /- 6 vs 68 + /- 12 mg daily ) . Plasma renin activity increased in both groups of patients , but more in group B ( p less than 0.05 ) . Plasma aldosterone concentrations and serum uric acid levels were also higher in the group receiving lisinopril plus hydrochlorothiazide ( p less than 0.05 ) . Serum potassium concentrations were unaffected in either group . The incidence of side effects was similar in groups A and B ( 44 % and 38 % , respectively ) . This study suggests that lisinopril alone or in combination with hydrochlorothiazide effectively lowers blood pressure in patients with essential hypertension without any major side effects
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 .