OBJECTIVE: To compare the effectiveness of the combination of @entity918 (HCT) plus sustained-release @entity594 with the combination of HCT plus @entity2515 in lowering @entity101 (BP) unresponsive to HCT monotherapy. DESIGN: An open, randomised crossover drug trial. SETTING: Outpatients' clinic in Parirenyatwa Hospital, Harare, a tertiary referral centre. SUBJECTS: 32 Black @entity1 of both sexes with newly diagnosed or previously treated @entity101 aged between 21 and 65 years who had a BP > 140/95 after receiving HCT 25 mg daily for four weeks were studied. INTERVENTION: @entity1 were kept on HCT 25 mg daily and were randomised to receive either @entity2515 0.25 mg daily or @entity594 (Adalat Retard) 20 mg bd for four weeks. This was followed by a two week washout period during which @entity1 received HCT 25 mg daily only. After the washout period @entity1 were crossed over to the alternative treatment for four weeks. @entity1 were kept on HCT 25 mg daily throughout the trial. MAIN OUTCOME MEASURES: The main outcome measure was the fall in BP which was taken as the difference between the BP at baseline and the BP at the end of each treatment period. Both systolic blood pressure (SBP) and diastolic blood pressure ( @entity11559 ) measurements were taken. RESULTS: Both second line drugs were effective in lowering SBP and @entity11559 and there was no significant difference between them. @entity594 reduced SBP by 18.9 mmHg (95% CI 12.1 to 25.7) and @entity11559 by 9.6 mmHg (95% CI 7.2 to 12.0). @entity2515 reduced SBP by 15.9 mmHg (95% CI 8.4 to 23.4) and @entity11559 by 11.1 mmHg (95% CI 7.5 to 14.6). However, only two @entity1 attained the target @entity11559 of < or = 90 mmHg after each active treatment period. CONCLUSION AND RECOMMENDATIONS: Since both agents were equally effective in reducing both SBP and @entity11559 and @entity2515 is much cheaper than @entity594 , it is recommended that for a developing country like Zimbabwe, the combination of HCT and @entity2515 at the above doses should be used as the first step to treat mild to moderate @entity101 without evidence of @entity16 . However, further trials should compare BP lowering effects as well as end organ protection offered by the trial drugs.

A randomised crossover comparison of @entity2515 and sustained-release XXXX in @entity101 .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity11559 :: ('CHEBI:35861', 'Chemical') :: ['DBP'] @entity101 :: ('MESH:D006973', 'Disease') :: ['high blood pressure', 'hypertension'] @entity918 :: ('MESH:D006852', 'Chemical') :: ['hydrochlorothiazide'] @entity2515 :: ('MESH:D012110', 'Chemical') :: ['reserpine', 'Reserpine'] @entity16 :: ('MESH:D009422', 'Disease') :: ['end organ damage'] @entity594 :: ('MESH:D009543', 'Chemical') :: ['nifedipine', 'Nifedipine']
@entity594 :: (MESH:D009543,Chemical) :: ['nifedipine']
