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Treating the older hypertensive: beta-blocker or diuretic?
Current Medical Research and Opinion
|January 1, 1985
Summary
Combined therapy with atenolol and hydrochlorothiazide/amiloride significantly lowered blood pressure in elderly patients compared to monotherapy. This combination offers enhanced hypertension control with manageable side effects.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Clinical Pharmacology
Background:
- Elderly patients often have inadequate blood pressure control with monotherapy.
- Beta-blockers and diuretics are common antihypertensive agents.
- Optimizing treatment for hypertension in older adults is crucial.
Purpose of the Study:
- To compare the efficacy of atenolol, hydrochlorothiazide/amiloride, and their combination in elderly hypertensive patients.
- To assess blood pressure reduction and side effects of different antihypertensive regimens.
- To evaluate biochemical parameter shifts with diuretic use in this population.
Main Methods:
- Randomized, prospective, double-blind study.
- 26 elderly patients with inadequate blood pressure control on monotherapy.
- Comparison of atenolol (50 mg), amiloride (5 mg)/hydrochlorothiazide (50 mg), and combined therapy.
Main Results:
- Combined therapy significantly reduced lying (p<0.01) and standing (p<0.05) systolic blood pressure more than monotherapy.
- Combined therapy showed greater reduction than diuretic alone on lying (p<0.05) and standing (p<0.01) blood pressure.
- Side effects were additive with combined treatment; no clinically significant potassium alterations were observed.
Conclusions:
- Combination therapy of atenolol and hydrochlorothiazide/amiloride is more effective for blood pressure control in elderly patients than monotherapy.
- This combination provides enhanced antihypertensive effects with a similar side effect profile to monotherapy.
- Diuretic use in elderly hypertensives may cause biochemical shifts, but serum potassium remains stable.
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