COMPARATIVE-STUDY OF THE EFFICACY AND TOLERABILITY OF HYDROFLUMETHIAZIDE VERSES PROPRANOLOL IN AFRICANS WITH MILD-TO-MODERATE HYPERTENSION

Sixty patients with Diastolic Blood Pressure (DBP) of 100-110 mmHg mat ched for age, sex and Bp levels were randomly assigned to propranolol 80mg daily or Hydroflumethiazide (HFM) 50mg daily. HFM causes a signif icant reduction in systolic blood pressure (SBP) and DBP within 4 week s compared both with baseline and propranolol (SBP 143.7 +/- 12.3 vs 1 58.1 +/- 10.9 mmHg, P<0.05; DBP 92.0 +/- 4.5 vs 102.4 +/- 5.1 mmHg, P< 0.05), (SBP 143.7 +/- 12.2 vs 152 +/- 11.0 mmHg P<0.05; DBP 92.0 +/- 4 .5 vs 101.1 +/- 6.1 mmHg, P<0.05), respectively. Propranolol produced no significant difference from the baseline at 4 weeks (SBP 152.0 +/- H.0 vs 154.1 +/- 11.5 mmHg NS; DBP 101.1 +/- 6.1 vs 102.2 +/- 5.6 mmHg , NS). Reduction in BP by HFM was maintained after 8 and 12 weeks with further reduction but which did not achieve statistical significance. Increased dose of propranolol (160mg daily) after 4 weeks caused sign ificant reduction in BP by 8 week (SBP 146.8 +/- 11.8 vs 152.0 +/- 11. 0 mmHg, P<0.05; DBP 95.9 +/- 4.4 vs 101.1 +/- 6.1 mmHg P<0.05), which was maintained up to 12 weeks. The values however remained higher than in the HFM group. More patients in the HFM group achieved target BP ( <140/90), SBP 53.8% vs 29.6% P<0.05, DBP 69.2% vs 14.8% P<0.01. Incide nce of side effects was similar and will be discussed. Thiazides are s uperior to B'blockers as initial monotherapy in black hypertensives.