Efficacy of a combination of diuretic, beta-blocker and vasodilator in the treatment of hypertension in general practice
Forrest, W.A.
British Journal of Clinical Practice 32(11): 326-332
1978
ISSN/ISBN: 0007-0947 PMID: 737111 Document Number: 4069
Fifteen hundred male and female patients with previously untreated hypertension were treated in stepwise fashion with three incremental regimens with the aim of reducing the blood pressure to 160/90 mmHg. Treatment 1 was sustained release (SR) oxprenolol 160 mg and cyclopenthiazide 0.25 mg given once daily. Treatment 2 was double this daily dose, SR oxprenolol 320 mg, and cyclopenthiazide 0.5 mg. Treatment 3 consisted of Treatment 2 plus the vasodilator hydralazine, 50-200 mg daily. One hundred and ninety one patients (12.7% of the total) withdrew from the study, of whom 131 were for drug-related reasons. The 1,309 patients who completed the study responded to these treatments as follows, where 'control' represents a blood pressure of<160/90 mmHg. 367 patients (24.5% of the total) were controlled with Treatment 1, and 545 patients (36.3%) with Treatment 2. When the vasodilator was added in Treatment 3 control was achieved in a further 340 patients (22.7%). The average blood pressure of the remaining 57 patients (3.8%) who were inadequately controlled was 166/100 mmHg. This drug regime was well tolerated by the majority of patients, and the incidence of persistently troublesome side-effects was low, even in patients taking the triple combination. The combination of diuretic, (3-blocker and vasodilator appears an effective and feasible therapy for moderately severe hypertensive patients in conditions of general practice.
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