Tft. Antonios et al., A DIURETIC IS MORE EFFECTIVE THAN A BETA-BLOCKER IN HYPERTENSIVE PATIENTS NOT CONTROLLED ON AMLODIPINE AND LISINOPRIL, Hypertension, 27(6), 1996, pp. 1325-1328
The combination of an angiotensin-converting enzyme inhibitor and a ca
lcium antagonist has a synergistic effect in patients with more severe
hypertension. However. when this combination fails to control blood p
ressure, it is not clear which drug is then additive. The aim of this
work was to study in a double blind; randomized, crossover design the
effect on blood pressure of the addition of either a thiazide diuretic
(bendrofluazide, 5 mg once daily) or a beta-blocker (atenolol, 100 mg
once daily) or placebo each for a month in hypertensive patients who
are not adequately controlled on the combined treatment of amlodipine
5 mg once daily and lisinopril 5 mg twice daily. Eighteen patients wit
h a supine diastolic pressure of more than 90 mm Hg after at least 1 m
onth on the combined treatment of amlodipine and lisinopril were enrol
led in the study. The results show thar in patients whose blood pressu
res are not controlled by the combination of amlodipine and lisinopril
, the addition of bendrofluazide 5 mg once daily causes a significant
fall in blood pressure compared with placebo and a significantly great
er fall than 100 mg atenolol once daily.