Formal comparison of the antihypertensive effects of torasemide and other diuretics by the Montevideo mathematical model
Reyes, A.J.
Arzneimittel-Forschung 38(1a): 194-199
1988
ISSN/ISBN: 0004-4172 PMID: 3370066 Document Number: 317494
A formal comparison is carried out of the antihypertensive effect of torasemide (1-isopropyl-3-{]4-(3-methyl-phenylamino)pyridine]-3-sulfonyl}urea) and various other diuretics used as monotherapy. The analyzed data are the results of various independent studies. The time (t) courses of the mean values of supine or sitting systolic (S) and diastolic (D) arterial blood pressure (P) during treatment are analyzed by fitting the "Montevideo mathematical model", described here, to the clinical (experimental) data. Clinically-important values of P and t evaluated before the fitted functions permit the formal comparisons. Decays in P were evaluated by the reductions in SP and DP occurred at 1.17 and 7.54 weeks of treatment, by the times at which the fitted functions showed diminutions of 10, 15 and 20 mmHg and of 10%, 15% and 20% with respect to pretreatments SP and DP mean values, and by the time at which DP attained a value of 90 mmHg. In studies in which the pretreatment mean value of DP ranged between 105.6 and 110.5 mmHg, standard-dose indapamide (2.5 to 5 mg/d), and low-dose torasemide (2.5 to 5 mg/d) elicited similar decays in SP and DP; the antihypertensive effects of etozoline (200 to 400 mg/d) and of hydrochlorothiazide (25 to 50 mg/d) were slower than those of torasemide and indapamide. Cyclothiazide (5 mg/d) and a coprescribed sodium-restricted diet reduced DP, from a pretreatment mean value of 114 mmHg, slower than torasemide and indapamide but quicker than etozoline and hydrochlorothiazide. Torsamide and indapamide should be consequently preferred for the chronic treatment of uncomplicated essential hypertension in terms of efficacy. Discrimination between these agents should be based upon their potentiality for causing unwanted effects.