Results of combination anti-hypertensive therapy after failure of each of the components

B. J. Materson, D. J. Reda, William Cushman, W. G. Henderson

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

We randomised ambulatory men with diastolic blood pressure (BP) 95-109 mm Hg without anti-hypertensive medication to single drug treatment with either hydrochlorothiazide 12.5-50 mg/day, atenolol 25-100 mg/day, captopril 25-100 mg/day, clonidine 0.2-0.6 mg/day, diltiazem-SR 120-360 mg/day, prazosin 4-20 mg/day or placebo in a double-blind prospective trial. The assigned drug was titrated to a goal BP of < 90 mm Hg. Patients not achieving goal BP were re-randomised to an alternative single active drug. Non-responders to the second drug received the first drug in combination with the second. Of the 102 non-responders to both drugs who qualified for the combination, 59 (57.8%) responded. The combination pairs that included a diuretic achieved diastolic goal BP in 69% and < 140 mm Hg systolic in 77% compared with 51% and 46%, respectively, for those combinations without a diuretic (P = 0.067; P = 0.002). Six of the eight terminations due to adverse drug reactions were in combinations containing prazosin; three of these six were hypotensive reactions. We conclude that two single drugs of insufficient efficacy to control BP individually have a high probability of achieving goal BP when combined, especially if the combination contains a diuretic.

Original languageEnglish (US)
Pages (from-to)791-796
Number of pages6
JournalJournal of Human Hypertension
Volume9
Issue number10
StatePublished - Nov 10 1995
Externally publishedYes

Fingerprint

Antihypertensive Agents
Blood Pressure
Diuretics
Pharmaceutical Preparations
Prazosin
Therapeutics
Hydrochlorothiazide
Atenolol
Diltiazem
Captopril
Clonidine
Drug Combinations
Drug-Related Side Effects and Adverse Reactions
Placebos

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Results of combination anti-hypertensive therapy after failure of each of the components. / Materson, B. J.; Reda, D. J.; Cushman, William; Henderson, W. G.

In: Journal of Human Hypertension, Vol. 9, No. 10, 10.11.1995, p. 791-796.

Research output: Contribution to journalArticle

Materson, B. J. ; Reda, D. J. ; Cushman, William ; Henderson, W. G. / Results of combination anti-hypertensive therapy after failure of each of the components. In: Journal of Human Hypertension. 1995 ; Vol. 9, No. 10. pp. 791-796.
@article{687f25fff8a04c8b9bdd02005ec6494f,
title = "Results of combination anti-hypertensive therapy after failure of each of the components",
abstract = "We randomised ambulatory men with diastolic blood pressure (BP) 95-109 mm Hg without anti-hypertensive medication to single drug treatment with either hydrochlorothiazide 12.5-50 mg/day, atenolol 25-100 mg/day, captopril 25-100 mg/day, clonidine 0.2-0.6 mg/day, diltiazem-SR 120-360 mg/day, prazosin 4-20 mg/day or placebo in a double-blind prospective trial. The assigned drug was titrated to a goal BP of < 90 mm Hg. Patients not achieving goal BP were re-randomised to an alternative single active drug. Non-responders to the second drug received the first drug in combination with the second. Of the 102 non-responders to both drugs who qualified for the combination, 59 (57.8{\%}) responded. The combination pairs that included a diuretic achieved diastolic goal BP in 69{\%} and < 140 mm Hg systolic in 77{\%} compared with 51{\%} and 46{\%}, respectively, for those combinations without a diuretic (P = 0.067; P = 0.002). Six of the eight terminations due to adverse drug reactions were in combinations containing prazosin; three of these six were hypotensive reactions. We conclude that two single drugs of insufficient efficacy to control BP individually have a high probability of achieving goal BP when combined, especially if the combination contains a diuretic.",
author = "Materson, {B. J.} and Reda, {D. J.} and William Cushman and Henderson, {W. G.}",
year = "1995",
month = "11",
day = "10",
language = "English (US)",
volume = "9",
pages = "791--796",
journal = "Journal of Human Hypertension",
issn = "0950-9240",
publisher = "Nature Publishing Group",
number = "10",

}

TY - JOUR

T1 - Results of combination anti-hypertensive therapy after failure of each of the components

AU - Materson, B. J.

AU - Reda, D. J.

AU - Cushman, William

AU - Henderson, W. G.

PY - 1995/11/10

Y1 - 1995/11/10

N2 - We randomised ambulatory men with diastolic blood pressure (BP) 95-109 mm Hg without anti-hypertensive medication to single drug treatment with either hydrochlorothiazide 12.5-50 mg/day, atenolol 25-100 mg/day, captopril 25-100 mg/day, clonidine 0.2-0.6 mg/day, diltiazem-SR 120-360 mg/day, prazosin 4-20 mg/day or placebo in a double-blind prospective trial. The assigned drug was titrated to a goal BP of < 90 mm Hg. Patients not achieving goal BP were re-randomised to an alternative single active drug. Non-responders to the second drug received the first drug in combination with the second. Of the 102 non-responders to both drugs who qualified for the combination, 59 (57.8%) responded. The combination pairs that included a diuretic achieved diastolic goal BP in 69% and < 140 mm Hg systolic in 77% compared with 51% and 46%, respectively, for those combinations without a diuretic (P = 0.067; P = 0.002). Six of the eight terminations due to adverse drug reactions were in combinations containing prazosin; three of these six were hypotensive reactions. We conclude that two single drugs of insufficient efficacy to control BP individually have a high probability of achieving goal BP when combined, especially if the combination contains a diuretic.

AB - We randomised ambulatory men with diastolic blood pressure (BP) 95-109 mm Hg without anti-hypertensive medication to single drug treatment with either hydrochlorothiazide 12.5-50 mg/day, atenolol 25-100 mg/day, captopril 25-100 mg/day, clonidine 0.2-0.6 mg/day, diltiazem-SR 120-360 mg/day, prazosin 4-20 mg/day or placebo in a double-blind prospective trial. The assigned drug was titrated to a goal BP of < 90 mm Hg. Patients not achieving goal BP were re-randomised to an alternative single active drug. Non-responders to the second drug received the first drug in combination with the second. Of the 102 non-responders to both drugs who qualified for the combination, 59 (57.8%) responded. The combination pairs that included a diuretic achieved diastolic goal BP in 69% and < 140 mm Hg systolic in 77% compared with 51% and 46%, respectively, for those combinations without a diuretic (P = 0.067; P = 0.002). Six of the eight terminations due to adverse drug reactions were in combinations containing prazosin; three of these six were hypotensive reactions. We conclude that two single drugs of insufficient efficacy to control BP individually have a high probability of achieving goal BP when combined, especially if the combination contains a diuretic.

UR - http://www.scopus.com/inward/record.url?scp=0028834791&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028834791&partnerID=8YFLogxK

M3 - Article

VL - 9

SP - 791

EP - 796

JO - Journal of Human Hypertension

JF - Journal of Human Hypertension

SN - 0950-9240

IS - 10

ER -