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 .
Effects of enalapril alone, and in combination with hydrochlorothiazide, on renin-angiotensin-aldosterone, renal function, salt and water excretion, and body fluid composition.
Enalapril is a new , oral , long-acting nonsulfhydral angiotensin converting enzyme inhibitor . Thirty-nine patients with primary hypertension were entered into a r and omized , double-blind protocol to assess the efficacy of enalapril ( 10 to 20 mg bid ) , hydrochlorothiazide ( 25 to 50 mg bid ) , or combined drug therapy . Enalapril , either alone or in combination with hydrochlorothiazide , effectively controlled blood pressure .  Enalapril monotherapy was associated with an increase in plasma renin activity and a decrease in angiotensin II concentration ; in patients with an initial inulin clearance less than or equal to 80 mL/min/1.73 m2 , inulin and para-aminohippurate clearances were markedly improved , without producing adverse effects on salt and water excretion or body fluid composition . Combination therapy was associated with a marked increase in plasma renin activity ; however , only those patients with an initial inulin clearance less than or equal to 80 mL/min/1.73 m2 demonstrated suppression of angiotensin II concentration and marked improvement in inulin and para-aminohippurate clearances . These observations suggest that enalapril , either alone or in combination with a diuretic , has the potential to reverse renal function abnormalities encountered in the hypertensive state
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 .