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Antihypertensive and Metabolic Effects of Hydrochlorothiazide, Amiloride—Hydrochlorothiazide, and Timolol
Author(s) -
CHRYSANT STEVEN G.,
BROWN JANET L.,
HAGSTROM DAVID
Publication year - 1983
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1983.tb02718.x
Subject(s) - hydrochlorothiazide , amiloride , timolol , medicine , thiazide , blood pressure , diuretic , pharmacology , endocrinology , chemistry , intraocular pressure , sodium , surgery , organic chemistry
The antihypertensive and metabolic effects of hydrochlorothiazide and amiloride—hydrochlorothiazide combination, alone and in combination with timolol, were studied in 26 patients with mild to moderately severe uncomplicated essential hypertension. All drugs were given in single daily doses as follows: hydrochlorothiazide 50 mg/day, amiloride—hydrochlorothiazide 5/50 mg/day (5 mg amiloride and 50 mg hydrochlorothiazide), timolol 20 mg/day. After six weeks of placebo treatment, the 26 patients were equally randomized into a double—blind HCTZ and HCTZ‐amiloride treatment period (weeks 7–18). Timolol was added to both groups of patients if the supine diastolic pressure at week 10 was higher than 90 mm Hg. Drug washout effects were observed for two weeks (weeks 19–20). Hydrochlorothiazide and amiloride—hydrochlorothiazide significantly lowered systolic and diastolic arterial pressure with the patient in the supine and upright position; the addition of timolol reduced the pressure further, and its effect was smooth and sustained. The heart rate was not affected by hydrochlorothiazide and amiloride—hydrochlorothiazide but was significantly decreased with the addition of timolol. The most common clinical and metabolic side effects observed, although not serious, were bradycardia from timolol and hypokalemia from hydrochlorothiazde. No hyperkalemia was noted with the combination of amiloride—hydrochlorothiazide and timolol. The results of the present study indicate that (1) the combination of timolol with either hydrochlorothiazide or amiloride—hydrochlorothiazide has equivalent antihypertensive actions; (2) the drugs can be effectively given in single daily doses; and (3) the combination of timolol with amiloride—hydrochlorothiazide has the additional advantage of preventing hypokalemia.