A DOUBLE-BLIND CROSSOVER STUDY OF THE EFFECT OF CONCOMITANT DIURETIC THERAPY IN HYPERTENSIVE PATIENTS TREATED WITH AMLODIPINE

被引:18
作者
CAPPUCCIO, FP [1 ]
MARKANDU, ND [1 ]
SINGER, DRJ [1 ]
BUCKLEY, MG [1 ]
MILLER, MA [1 ]
SAGNELLA, GA [1 ]
MACGREGOR, GA [1 ]
机构
[1] ST GEORGE HOSP,SCH MED,DEPT MED,BLOOD PRESSURE UNIT,CRANMER TERRACE,LONDON SW17 0RE,ENGLAND
关键词
AMLODIPINE; THIAZIDES; BLOOD PRESSURE;
D O I
10.1093/ajh/4.4.297
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Twelve patients with essential hypertension who were already on treatment with the long-acting calcium antagonist amlodipine (5 mg once daily) were entered into a double-blind, randomized crossover study of the addition of one month's treatment with either bendrofluazide (5 mg once daily) or matching placebo. The addition of bendrofluazide did not cause any statistically significant fall in the supine blood pressure compared to treatment with placebo (147.6/90.1 +/- 4.8/2.8 v 150.8/92.6 +/- 4.3/2.3 mm Hg, respectively). Plasma potassium was significantly lower on bendrofluazide as compared to placebo (3.11 +/- 0.14 v 3.62v +/- 0.13 mmol/L, P < .001) and 10 of 12 patients had a fall in plasma potassium while on diuretic. The results of this study suggest that a thiazide diuretic has little additive effect on blood pressure in patients already on the long-acting dihydropyridine amlodipine, and may cause hypokalemia.
引用
收藏
页码:297 / 302
页数:6
相关论文
共 35 条
  • [1] Weinberger M.H., Diuretics and their side effects. Dilemma in the treatment of hypertension, Hypertension, 2, pp. 16-20, (1988)
  • [2] Macgregor G.A., Hypertension, Treatment of Cardiovascular Diseases by Adalat, pp. 231-258, (1986)
  • [3] Hallin L., Ren L., Hansson L., Controlled trial of nifedipine and bendroflumethiazide in hypertension, J Car-Diovasc Pharmacol, 5, pp. 1083-1085, (1983)
  • [4] Marone C., Luisoli S., Bomio F., Et al., Pressor factors and cardiovascular pressor responsiveness after short-term antihypertensive therapy with the calcium antagonist nifedipine alone or combined with a diuretic, J Hyper-Tens, 2, pp. 449-452, (1984)
  • [5] Cappuccio F.P., Markandu N.D., Tucker F.A., Et al., Does a diuretic cause a further fall in blood pressure in hypertensive patients already on nifedipine?, J Clin Hypertens, 4, pp. 346-353, (1986)
  • [6] Cappuccio F.P., Markandu N.D., Tucker F.A., Et al., A double-blind study of the blood pressure lowering effect of a thiazide diuretic in hypertensive patients already on nifedipine and a beta-blocker, J Hypertens, 5, pp. 733-738, (1987)
  • [7] Macgregor G.A., Pevahouse J.B., Cappuccio F.P., Et al., Nifedipine, sodium intake, diuretics and sodium balance, Am J Nephrol, 7, pp. 44-48, (1987)
  • [8] Poulter N.R., Thompson A.V., Sever P.S., A double-blind, placebo-controlled, crossover trial to investigate the additional hypotensive effect of a diuretic (Mefruside) to that produced by nifedipine, J Cardiovasc Pharmacol, 10, pp. 53-56, (1987)
  • [9] Salvetti A., Magagna A., Innocenti P., Et al., Chlorthalidone does not increase the hypotensive effect of nifedipine in essential hypertensives in a crossover multicentre study, J Hypertens, 7, pp. 250-251, (1989)
  • [10] Nicholson J.P., Resnick L.M., Laragh J.H., Hydrochlorothiazide is not additive to verapamil in treating essential hypertension, Arch Intern Med, 149, pp. 125-128, (1989)