"Third drug" trial: comparative study of antihypertensive agents added to treatment when blood pressure remains uncontrolled by a beta blocker plus thiazide diuretic.

McAreavey, Dorothea; Ramsey, Lenny; Latham, L. P.; McLaren, Andrew; Lorimer, A. R.; Reid, JL; Robertson, James I.; Robertson, M P; Weir, R. J.

doi:10.1136/bmj.288.6411.106

Cited by 66 publications

(18 citation statements)

References 19 publications

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“…16,17 However, a considerable proportion of hypertensive patients exhibit an inadequate response to monotherapy with ACE inhibitors, as was the case in our patients. 3,18 In such cases, the addition of a diuretic to a standard dose of ACE inhibitor gives a better response than increasing the dose of ACE inhibitor. 4 Thus, the combination of ACE inhibitors with diuretics appears to represent an ideal choice in terms of efficacy, compliance, side effects and cost.…”

Section: Discussionmentioning

confidence: 99%

“…In the remaining patients, a synergistic effect upon hypotensive efficacy has been observed when even small doses of diuretics are added. [2][3][4][5] Even though diuretics exert adverse metabolic effects, ACE inhibitors appear to exhibit a neutral or even a beneficial effect on lipid and carbohydrate metabolism, leading to an attenuation of the biochemical sequalae commonly associated with diuretic therapy. [6][7][8][9][10][11] However, indapamide has been reported to induce a moderate change in the serum metabolic parameters.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension

et al. 1999

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The effectiveness as well as the metabolic effects of the combination of diuretics [hydrochlorothiazide (HCT) vs indapamide (IND)] and perindopril (P) in 14 patients (7 male, 7 female) aged 37-62 years with mild idiopathic hypertension were studied. Following a 4-week washout period and a 4-week period of monotherapy with P (4 mg/daily), IND (2.5 mg/daily) or HCT (25 mg/daily) was added for 4 weeks. Selection of the diuretic agent was random. Following a 4-week wash-out period from the diuretic, in which only P was given, the alternative diuretic was administered for another period of 4 weeks. P decreased blood pressure levels significantly. However, the drug was more efficacious in patients with higher plasma renin activity (PRA). Combination treatment induced an additional decrease in the blood pressure levels, mainly in patients with lower PRA. The combination of P ؉ HCT was more effective than the combination P ؉ IND. The addition of either HCT or IND

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension

et al. 1999

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“…Diuretic therapy showed inappropriately BP control in this study. Two randomized, placebo-controlled trials on the use of combination therapy with diuretics and β-blockers for the treatment of uncontrolled hypertension reported that there were no statistically significant differences in the BPlowering effects or tolerability among the various third-line agents (23,24). Further carefully controlled clinical trials will be needed to determine the most cost-effective approach for improving BP control and reducing cardiovascular risk.…”

Section: Resistant Hypertensionmentioning

confidence: 99%

Relation of Pulsatility of Brachial Artery Pressure to Resistant Hypertension

Yoshitomi¹,

Nagakura²,

Miyauchi³

2004

Hypertens Res

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“…Similar results have been ob tained when prazosin was used with betareceptor-blocking drugs. Prazosin can be used as an alternative to hydralazine in stan dard triple therapy [45]. In patients not con trolled by diuretic and beta blocker, the addi tion of prazosin may be useful [45],…”

Section: Prazosin and Other Antihypertensive Drugsmentioning

confidence: 99%

Clinical Pharmacology and Therapeutic Role of Prazosin and Related Alpha-Adrenoceptor Antagonists

Reid¹,

Vincent²

1986

Cardiology

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Prazosin is a quinazoline derivative, which lowers blood pressure by selective alpha-1-receptor antagonism. It has been found that, for similar decreases in blood pressure, prazosin causes less reflex tachycardia than non-selective alpha blockers or direct vasodilators, and that it is as efficacious as other conventional antihypertensive agents (alpha-methyldopa, hydralazine, beta blockers, etc.) in controlling severe hypertension. Prazosin causes a dose-related decrease in blood pressure in humans; twice-daily dosing is sufficient for 24-hour blood pressure control. Prazosin in combination with other drugs has also been shown to control blood pressure effectively, and it has been associated with relatively few side effects. Other agents with selective alpha-1-receptor-blocking activity are under investigation: these include doxazosin, trimazosin, terazosin, and alfuzosin.

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"Third drug" trial: comparative study of antihypertensive agents added to treatment when blood pressure remains uncontrolled by a beta blocker plus thiazide diuretic.

Cited by 66 publications

References 19 publications

Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension

Effectiveness and metabolic effects of perindopril and diuretics combination in primary hypertension

Relation of Pulsatility of Brachial Artery Pressure to Resistant Hypertension

Clinical Pharmacology and Therapeutic Role of Prazosin and Related Alpha-Adrenoceptor Antagonists

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