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Third-line therapy. A cautionary note.

J Conway

    Clinical and Experimental Hypertension. Part A, Theory and Practice
    |January 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Adding a third medication for hypertension is often ineffective. Many patients require trying multiple drug options to control blood pressure effectively when initial treatments fail.

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    Area of Science:

    • Cardiology
    • Pharmacology

    Background:

    • Dual therapy with diuretics and beta-blockers is a common first-line treatment for hypertension.
    • Some patients do not achieve adequate blood pressure control with dual therapy.

    Purpose of the Study:

    • To evaluate the effectiveness of third-line antihypertensive agents in patients with resistant hypertension.
    • To compare captopril, nifedipine, and methyldopa as add-on therapies.

    Main Methods:

    • Ten patients with uncontrolled hypertension on dual therapy were enrolled.
    • Captopril, nifedipine, and methyldopa were administered sequentially as third-line treatments in a randomized order.
    • Patient responses to each agent were recorded.

    Main Results:

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  • Only one patient responded to all three third-line agents.
  • Two patients responded to nifedipine and captopril.
  • One patient responded only to captopril.
  • Four patients did not respond to any of the third-line agents.

    • Conclusions:

    • Third-line antihypertensive therapy is frequently ineffective in achieving blood pressure control.
    • Multiple medication trials may be necessary to find an effective agent for resistant hypertension.
    • Captopril and nifedipine showed some efficacy in a subset of patients.