RELATIVE VALUE OF BETA-BLOCKERS AND THIAZIDES FOR INITIATING ANTIHYPERTENSIVE THERAPY - BETA-BLOCKERS OR THIAZIDES IN HYPERTENSION

  • 1 January 1976
    • journal article
    • research article
    • Vol. 31  (5) , 411-426
Abstract
Fifty-five patients with mild to moderate, renal or essential hypertension were admitted to a double blind cross-over trial of 18 wk involving treatment periods with placebo, the thiazide bendrofluazide (15 mg daily) and the .beta.-blocker atenolol (600 mg daily). Compared to the placebo period (190/117 mm Hg) the hypotensive effect of atenolol (-24/16 mm Hg) was more pronounced than the hypotensive effect of bendrofluazide (-17/6 mm Hg). Arguments in favor of initiating antihypertensive drug therapy with a .beta.-blocker were its more powerful hypotensive effect, the quicker onset of its action, less metabolic disturbance, decreased frequency of complaints and patients preference. With thiazides, body weight and the frequency of swollen ankles decreased. Plasma renin concentration did not have a strong predicting power for the hypotensive effect of atenolol or bendrofluazide, but low renin patients showed a more pronounced blood pressure decrease on bendrofluazide than high renin patients, especially essential hypertensives, on atenolol. The preference of one drug over the other must eventually be based on their relative efficacy in decreasing morbidity and mortality from the hypertensive disease.