Combination therapy with diuretics: An evolution of understanding

Neutel, Joel M.; Black, Henry R.; Weber, Michael A.

doi:10.1016/s0002-9343(96)00269-0

Cited by 44 publications

(29 citation statements)

References 48 publications

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“…The proportion of patients requiring the addition of HCTZ to aliskiren therapy (46%) in order to achieve BP control was similar to that observed with aliskiren in a previous long-term, open-label study (45%) [13]. Combination therapy is needed to achieve BP control in the majority of patients with hypertension [3,21] and thiazide diuretics, such as HCTZ, are widely used in combination regimens [22]. In large-scale trials of patients with mild-to-moderate hypertension, approximately two-thirds of patients required combination treatment to achieve BP control [23][24][25].…”

Section: Discussionsupporting

confidence: 66%

Comparative efficacy and safety of aliskiren, an oral direct renin inhibitor, and ramipril in hypertension: a 6-month, randomized, double-blind trial

Andersen

Weinberger

Egan

et al. 2008

Journal of Hypertension

140

163

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Section: Discussionsupporting

confidence: 66%

Comparative efficacy and safety of aliskiren, an oral direct renin inhibitor, and ramipril in hypertension: a 6-month, randomized, double-blind trial

Andersen

Weinberger

Egan

et al. 2008

Journal of Hypertension

140

163

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“…Hydrochlorothiazide (HCTZ; 6-chloro-3,4-dihydro-2H-1,2,4-benzothiadiazine-7-sulfonamide 1,1dioxide; commercially known as Aquarius, Apo-Hydro, Atenadon, Bremil, Cidrex, Dichlotride, Esidrex, Fluvin, Hydro-Diuril, Hypothiazide, Ivaugan, Oretic, Neoflumen, Ridaq, Thiuretic and others) also is found in numerous multi-ingredient preparations [IARC, 1990;Neutel et al, 1996]. The chemical structure of HCTZ is shown in Figure 1.…”

Section: Test Agentmentioning

confidence: 99%

Genotoxicity of hydrochlorothiazide in cultured human lymphocytes. I. Evaluation of chromosome delay and chromosome breakage

Andrianopoulos

Stephanou

Demopoulos

2005

Environ and Mol Mutagen

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Hypertension is often treated with diuretics, like hydrochlorothiazide (HCTZ). Previous results on the in vitro genotoxicity of HCTZ are equivocal. In the present study, we have evaluated the genotoxicity of HCTZ in cultured human lymphocytes using the Cytokinesis Blocked Micronucleus (CBMN) assay. In addition, micronucleus (MN) induction was analyzed by Fluorescence In Situ Hybridization (FISH) with an alpha-satellite DNA centromeric probe to distinguish between clastogenic and aneugenic effects. Lymphocyte cultures from 32 healthy adults were exposed to 5 and 40 microg/ml HCTZ. Age, gender, and smoking were evaluated as factors affecting the MN analysis. We found that HCTZ increased MN frequencies. FISH analysis revealed that HCTZ exerts its genotoxicity more strongly at the 40 microg/ml concentration, and principally through chromosome delay (aneugenicity). Multiregression analysis of our results confirmed the known effect of age and gender on MN induction in human lymphocytes. Smoking was also a confounding factor for MN induction, especially for centromere-negative MN frequencies. Under the experimental conditions used, only age had a clear positive effect on the response of lymphocytes to HCTZ. These data indicate that HCTZ produces micronuclei in cultured human lymphocytes by a mechanism that involves chromosome delay and to a lesser extent through chromosome breakage.

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“…The addition of a diuretic, such as hydrochlorothiazide (HCTZ), can result in an increase in response rate to about 80-85% in patients insufficiently responsive to monotherapy. 9,10 Antihypertensive agents that inhibit the RAAS are known to be more effective in some patients than others. Thiazide diuretics act as vasodilators by increasing the excretion of water and solutes, mainly NaCl.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of eprosartan in combination with HCTZ in patients with essential hypertension

2002

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This randomised, double-blind study was designed to investigate the efficacy of a once-daily (OD) combination of the AT 1 receptor blocker, eprosartan 600 mg, and the thiazide diuretic, hydrochlorothiazide (HCTZ) 12.5 mg, in patients with mild to moderate hypertension (sitting diastolic blood pressure (sitDBP) у98 mm Hg and р114 mm Hg) not adequately controlled with eprosartan 600 mg OD. A total of 494 patients entered the open-label monotherapy run-in phase, which consisted of eprosartan 600 mg OD for 3 weeks. Patients who responded to monotherapy were not eligible to enter the randomised phase of the study and were withdrawn. The remaining 309 patients were then randomised to either eprosartan 600 mg plus HCTZ 12.5 mg OD or to continue on eprosartan 600 mg OD. In the eprosartan plus HCTZ combination group, both sitDBP and sitting systolic blood pressure (sitSBP) were significantly

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Combination therapy with diuretics: An evolution of understanding

Cited by 44 publications

References 48 publications

Comparative efficacy and safety of aliskiren, an oral direct renin inhibitor, and ramipril in hypertension: a 6-month, randomized, double-blind trial

Comparative efficacy and safety of aliskiren, an oral direct renin inhibitor, and ramipril in hypertension: a 6-month, randomized, double-blind trial

Genotoxicity of hydrochlorothiazide in cultured human lymphocytes. I. Evaluation of chromosome delay and chromosome breakage

Efficacy of eprosartan in combination with HCTZ in patients with essential hypertension

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