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Effect of timolol plus hydrochlorothiazide plus hydralazine on essential hypertension
Insights
Hydrochlorothiazide plus timolol effectively lowers blood pressure in hypertensive patients. Adding hydralazine further enhanced this effect with good tolerability and fewer side effects.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Clinical Hypertension Research
Background:
- Hypertension management often requires combination therapy.
- Assessing the efficacy and tolerability of antihypertensive drug combinations is crucial.
Purpose of the Study:
- To evaluate the efficacy and tolerability of hydrochlorothiazide plus timolol compared to hydrochlorothiazide alone.
- To assess the combination of hydrochlorothiazide, timolol, and hydralazine against hydrochlorothiazide and hydralazine with placebo.
Main Methods:
- A double-blind, randomized, crossover study involving 38 hypertensive patients.
- Comparison of drug regimens including hydrochlorothiazide (100 mg/day) with timolol (20-60 mg/day) or placebo.
- Evaluation of adding hydralazine (40-200 mg/day) to hydrochlorothiazide plus timolol versus hydrochlorothiazide plus placebo plus hydralazine.
Main Results:
- Hydrochlorothiazide plus timolol demonstrated superior blood pressure reduction compared to hydrochlorothiazide plus placebo.
- The triple-drug regimen (hydrochlorothiazide, timolol, hydralazine) was highly effective in reducing both supine and standing systolic and diastolic blood pressures.
- Patients tolerated the triple-drug regimen better, experiencing greater blood pressure reduction and fewer side effects than with hydrochlorothiazide plus placebo plus hydralazine.
Conclusions:
- Combination therapy with hydrochlorothiazide and timolol is effective for hypertension.
- Adding hydralazine to hydrochlorothiazide and timolol provides significant antihypertensive benefits with good tolerability.
Abstract:
The effect on hypertension of hydrochlorothiazide 100 mg daily plus timolol 20-60 mg daily versus hydrochlorothiazide plus placebo and of hydrochlorothiazide plus timolol plus hydralazine 40-200 mg daily versus hydrochlorothiazide plus placebo plus hydralazine was evaluated in a double-blind, randomized, crossover study in 38 patients with hypertension. Hydrochlorothiazide plus timolol was more effective than hydrochlorothiazide plus placebo in lowering both supine and standing systolic and diastolic blood pressures. Hydrochlorothiazide plus timolol plus hydralazine was a very effective regimen in lowering both supine and standing systolic and diastolic blood pressure. The patients tolerated this regimen well with greater hypotensive activity and a lower incidence of side effects than on hydrochlorothiazide plus placebo plus hydralazine.