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 .
Quinapril, hydrochlorothiazide, and combination in patients with moderate to severe hypertension.
This 8-week , double-blind , multicentre study compared the efficacy and safety of the combination of quinapril and hydrochlorothiazide ( HCTZ ) with each drug as monotherapy . Out patients with moderate to severe hypertension defined as supine diastolic blood pressure ( DBP ) > or = 105 mmHg and < or = 120 mmHg at the end of a 2 to 4-week placebo-baseline period were r and omly assigned to one of the three treatments : once-daily 10 mg quinapril plus 12.5 mg HCTZ or monotherapy with these doses . After 4 weeks , the doses were to be doubled for the remaining 4 weeks . Three hundred and sixty-eight patients were r and omized to double-blind medication ; 346 completed the study . Seven patients withdrew due to lack of efficacy . Four patients withdrew due to side effects .  In all three treatment groups , clinical ly significant reductions in DBP were achieved . Combination therapy was statistically more effective than each component taken as monotherapy . Adverse events were infrequent in all treatment groups . No patients experienced symptomatic hypotension or orthostatic hypotension
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 .