Abstract
The efficacy of various combinations of atenolol, bendrofluazide, and hydraliazine given twice daily was assessed in a double-blind trial on 39 patients with moderate to severe essential hypertension. Concurrent treatment with all three drugs proved most effective and produced a mean reduction in blood pressure of 43/31 mm Hg. In the dosage used, hydrallazine affected only the diastolic blood pressure, and when added to either bendrofluazide or bendrofluazide plus atenolol it produced a further mean reduction in pressure of 6 mm Hg. Once-daily treatment with atenolol and bendrofluazide was as effective in reducing blood pressure as the same combination given twice daily, and the hypotensive effect was still present at least 24 hours after the last dose of tablets. A combined tablet of atenolol and bendrofluazide taken once daily would be a simple regimen to follow and would provide almost as much hypotensive effect as a twice-daily regimen incorporating a modest dose of hydrallazine. The hypotensive effect of atenolol was equal to that of bendrofluazide on systolic pressure but significantly better than that of bendrofluazide on diastolic pressure. Atenolol reduced plasma renin and urate concentrations but increased plasma potassium levels. The biochemical effects of atenolol, therefore, may be an advantage over those of bendrofluazide when deciding on first-line treatment for essential hypertension.
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- Ahlmark G., Saetre H., Korsgren M. Letter: Reduction of sudden Deaths after myocardial infarction. Lancet. 1974 Dec 28;2(7896):1563–1563. doi: 10.1016/s0140-6736(74)90299-2. [DOI] [PubMed] [Google Scholar]
- Douglas-Jones A. P., Cruickshank J. M. Once-daily dosing with Atenolol in patients with mild or moderate hypertension. Br Med J. 1976 Apr 24;1(6016):990–991. doi: 10.1136/bmj.1.6016.990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Haber E., Koerner T., Page L. B., Kliman B., Purnode A. Application of a radioimmunoassay for angiotensin I to the physiologic measurements of plasma renin activity in normal human subjects. J Clin Endocrinol Metab. 1969 Oct;29(10):1349–1355. doi: 10.1210/jcem-29-10-1349. [DOI] [PubMed] [Google Scholar]
- Laragh J. H., Baer L., Brunner H. R., Buhler F. R., Sealey J. E., Vaughan E. D., Jr Renin, angiotensin and aldosterone system in pathogenesis and management of hypertensive vascular disease. Am J Med. 1972 May;52(5):633–652. doi: 10.1016/0002-9343(72)90054-x. [DOI] [PubMed] [Google Scholar]
- Prichard B. N., Gillam P. M. Treatment of hypertension with propranolol. Br Med J. 1969 Jan 4;1(5635):7–16. doi: 10.1136/bmj.1.5635.7. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Schröder H. Simplified method for determining acetylator phenotype. Br Med J. 1972 Aug 26;3(5825):506–507. doi: 10.1136/bmj.3.5825.506. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Skinner S. L. Improved assay methods for renin "concentration" and "activity" in human plasma. Methods using selective denaturation of renin substrate. Circ Res. 1967 Apr;20(4):391–402. doi: 10.1161/01.res.20.4.391. [DOI] [PubMed] [Google Scholar]
- Wilhelmsson C., Vedin J. A., Wilhelmsen L., Tibblin G., Werkö L. Reduction of sudden deaths after myocardial infarction by treatment with alprenolol. Preliminary results. Lancet. 1974 Nov 16;2(7890):1157–1160. doi: 10.1016/s0140-6736(74)90807-1. [DOI] [PubMed] [Google Scholar]
- Winchester J. F., Ward D. M., McKillop J. H., Kennedy A. C. Hydrallazine or phentolamine as adjuncts to beta-adrenoceptor blockade/thiazide therapy in hypertension. Br J Clin Pharmacol. 1976 Oct;3(5):863–867. doi: 10.1111/j.1365-2125.1976.tb00639.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zacest R., Gilmore E., Koch-Weser J. Treatment of essential hypertension with combined vasodilation and beta-adrenergic blockade. N Engl J Med. 1972 Mar 23;286(12):617–622. doi: 10.1056/NEJM197203232861201. [DOI] [PubMed] [Google Scholar]