Antihypertensive comparison of furosemide with hydrochlorothiazide for black patients

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Abstract
Furosemide and hydrochlorothiazide were compared for treatment of black patients with mild to moderate hypertension in a randomized, double-blind crossover study design. Hydrochlorothiazide produced a significantly greater fall in mean arterial (24.7 vs. 16.0 mm Hg, P < 0.01) and diastolic (17.3 vs. 10.1 mm Hg, P < 0.01) blood pressure (BP) in 16 patients. Addition of methyldopa in 9 patients produced a significantly greater fall in mean arterial (38.8 vs. 31.9 mm Hg, P < 0.05) and diastolic (28.9 vs. 23.4 mm Hg, P < 0.05) BP with hydrochlorothiazide vs. furosemide. Renin status was categorized before and after treatment. Patients with low and normal renin activity were equally responsive to both diuretics. Hydrochlorothiazide caused a greater reduction in plasma K (0.26 meq/l). Serum parathyroid hormone was not chronically elevated with furosemide. Hydrochlorothiazide was more effective than furosemide for treatment of mild to moderate hypertension in black patients; renin classification did not predict diuretic responsiveness.