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 .
Antihypertensive profiles with ascending dose combinations of ramipril and felodipine ER.
The aim of the study was to identify the most appropriate dosage combination of ramipril and felodipine ER ( an extended release tablet ) for mild-to-moderate hypertension . Hypertensive patients ( N = 507 ) with supinediastolic blood pressure ( DBP ) values between 100 - 115 mm Hg were included in a r and omized , multicenter , double-blind study of 3x4 factorial design with a 2 - 4 week single-blind , placebo run-in and 6 week active treatment phase . The patients were r and omized to 12 groups : placebo , ramipril ( 2.5 , 5 , 10 mg ) , felodipine ER ( 5 , 10 mg ) , or ramipril-felodipine ER combinations ( 2.5/5 mg , 2.5/10 mg , 5/5 mg , 5/10 mg , 10/5 mg , 10/10 mg ) . Although the greatest reductions in blood pressure were observed with ramipril-felodipine ER ( 10/10 mg ) , consideration of the antihypertensive efficacy and safety factors suggest that the ramipril-felodipine ER ( 5/5 mg ) combination has the best efficacy/tolerability ratio of the combinations tested . The incidence of adverse events with ramipril-felodipine ER  combination therapy was similar to that with felodipine ER monotherapy , but peripheral edema , tachycardia and vasodilatation occurred less frequently with ramipril-felodipine ER ( 5/5 mg ) combination than with felodipine ER monotherapy . The combination of ramipril-felodipine ER ( 5/5 mg ) can be considered to be the most suitable option for hypertensive patients with an inadequate response to either of the monocomponents
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 .