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 .
Study of the efficacy and safety of the combination ramipril 2.5 mg plus hydrochlorothiazide 12.5 mg in patients with mild-to-moderate hypertension. ATHES Study Group.
In a double-blind , parallel-group multicentre study , the efficacy and safety of a fixed low-dose combination of ramipril 2.5 mg and hydrochlorothiazide ( HCT ) 12.5 mg was compared with each of the component drugs when given as monotherapy . After a four-week placebo run-in , patients were r and omized to receive either ramipril 2.5 mg ( n = 218 ) or HCT 12.5 mg ( n = 220 ) , or the fixed-dose combination of ramipril 2.5 mg and HCT 12.5 mg ( n = 222 ) , for a period of eight weeks . At the end of the study , in which 624 patients had completed treatment , it was found that the decrease in supine diastolic blood pressure ( the main efficacy parameter ) was greater in the ramipril-HCT combination group than in either the ramipril or the HCT monotherapy groups , the difference being statistically significant when compared with the HCT group ( -14.3 , -13.1 and -12.4 mm Hg , respectively ) . Reductions in st and ing DBP and supine and st and ing systolic blood pressure ( SBP ) were also greatest in the combination group . The incidence of adverse events was lower in the combination group than in either of the monotherapy groups , and there were no serious clinical ly significant laboratory abnormalities in the combination group
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 .