We found no clinical ly meaningful blood pressure-lowering differences between different drugs within the loop diuretic class .
BACKGROUND Antihypertensive drugs from the thiazide diuretic drug class have been shown to reduce mortality and cardiovascular morbidity .
Loop diuretics are indicated and used to treat hypertension , but a systematic review of their blood pressure-lowering efficacy or effectiveness in terms of reducing cardiovascular mortality or morbidity from r and omized controlled trial ( RCT ) evidence has not been conducted .
OBJECTIVES To determine the dose-related decrease in systolic or diastolic blood pressure , or both , as well as adverse events leading to participant withdrawal and adverse biochemical effects ( serum potassium , uric acid , creatinine , glucose and lipids profile ) due to loop diuretics versus placebo control in the treatment of people with primary hypertension .
A Double-Blind Multicentre Study of Piretanide and Hydrochlorothiazide in Patients with Essential Hypertension
In a r and omized double-blind parallel group study conducted in three centres the hypotensive activity of piretanide 6 mg b.i.d . was compared with that of hydrochlorothiazide ( HCT ) 25 mg b.i.d . and HCT 50 mg b.i.d . Ninety-three patients entered the study and sixty-one completed a 16–week trial period . All three treatments produced a significant reduction in supine diastolic and systolic blood pressure after only 2 weeks of active treatment and this was maintained for the duration of the study . The mean maximal reduction in supine diastolic blood pressure was 18 % in the piretanide group , 18·8 % in the HCT 25 mg b.i.d . group , and 20 % in the HCT 50 mg b.i.d . group . The corresponding figures for the percentage of patients attaining a supine diastolic pressure below 95 mm Hg were 83 % , 62 % and 89 % . There were no significant differences between the three groups . Side-effects were generally mild and transient , except for polyuria which was noted in all three groups but more commonly in the piretanide group . Two patients were withdrawn because of side-effects : one patient in the high dose HCT group developed severe postural symptoms ; and one patient in the low dose HCT group was withdrawn because of restlessness , nausea , weakness , dizziness and somnolence . All three treatments caused a significant increase in serum uric acid concentrations . Four patients in each of the HCT groups developed hypokalemia , but no patients in the piretanide group did so
We found no clinical ly meaningful blood pressure-lowering differences between different drugs within the loop diuretic class .
BACKGROUND Antihypertensive drugs from the thiazide diuretic drug class have been shown to reduce mortality and cardiovascular morbidity .
Loop diuretics are indicated and used to treat hypertension , but a systematic review of their blood pressure-lowering efficacy or effectiveness in terms of reducing cardiovascular mortality or morbidity from r and omized controlled trial ( RCT ) evidence has not been conducted .
OBJECTIVES To determine the dose-related decrease in systolic or diastolic blood pressure , or both , as well as adverse events leading to participant withdrawal and adverse biochemical effects ( serum potassium , uric acid , creatinine , glucose and lipids profile ) due to loop diuretics versus placebo control in the treatment of people with primary hypertension .