Effectiveness of centrally acting drugs and diuretics in adolescent hypertension

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Abstract
The effectiveness and tolerance of a centrally acting antihypertensive agent (clonidine) was compared to that of a diuretic (hydrochlorothiazide) in treatment of adolescents with essential hypertension. After a phase on placebo, 29 adolescents with fixed primary hypertension were randomly assigned, double blind, to 1 of 2 treatment groups. Active therapy was initiated at a low dose (0.1 mg clonidine b.i.d. [twice a day] or 25 mg hydrochlorothiazide b.i.d.) for 12 wk. In those in whom treatment goals for blood pressure control had not been reached, the dose was increased (clonidine to 0.2 mg and hydrochlorothiazide to 50 mg) for 12 wk. In the clonidine-treated group there was a reduction during low-dose therapy in systolic (P < 0.05) and diastolic pressure (P < 0.01) and heart rate (P < 0.01). With low-dose diuretic therapy there was a reduction in systolic pressure only (P < 0.05). Linear growth patterns were normal for both groups, but there was a reduction in serum K in the diuretic group (P < 0.001). The centrally acting clonidine was more effective in blood pressure control (85%) than was the diuretic (40%).