Veterans Administration cooperative study on nadolol as monotherapy and in combination with a diuretic

A series of studies on various therapeutic aspects of beta-adrenergic-blocking drugs was carried out by the Veterans Administration Cooperative Study Group on Antihypertensive Agents. In one study the diastolic blood pressures of 49% of 132 men with mild to moderate hypertension were controlled (less than 90 mm Hg) with once-daily nadolol. In a similar group, 85% were controlled with nadolol plus bendroflumethiazide, both given once daily. Nadolol alone was as effective as diuretic alone, although in another study comparing propranolol and hydrochlorothiazide, the latter was somewhat more effective. In both trials black patients tended to respond better to the diuretic, whereas white patients responded better to the beta blocker. Although high-renin hypertensive patients tended to respond better to the beta blocker and low-renin patients to the diuretic, the relationships were not close enough to provide a dependable guide to treatment. Sixty percent of patients whose blood pressure was not controlled on the nadolol-containing regimens reached goal blood pressure (less than 90 mm Hg) with the addition of hydralazine, 25 to 100 mg twice daily.