The results of the comparative study of nadolol, propranolol, prazosin and hydrochlorothiazide in patients with arterial hypertension in a 12-month stepped-plan treatment (cooperative research). The Working Group of the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension. II. The results of combined therapy. Side effects. The reasons for dropouts. Conclusion.
The efficacy and safety of nadolol (N), propranolol (PP), prazosin (PS) and a diuretic (D) were studied and compared with the aid of a total systems approach in a cooperative open study with participation of 10 centers of the USSR. As many as 419 men suffering from arterial hypertension (diastolic AP 95 mm Hg) were entered into the study. After randomization the patients received one of the 4 drugs. In case the monotherapy failed, combinations of 2-3 drugs were administered. The treatment lasted one year, with a monthly control being exercised. The patients' from the study accounted for 15% including the final points which constituted 1.9%. Of these, 6 patients suffered myocardial infarctions (one with a fatal outcome) and 2 presented with cerebral circulatory disorders. 3.8% of the patients were withdrawn from the study because of the side effects of the drugs. Out of 356 patients who completed the studies, 36.8% received one, 43% two, and 20.2% three drugs by the end of the year. The protocol of the study and the results of the monotherapy were provided in Communication I. Combined therapy with two or three drugs was effective whatever the combination and brought about a 12-16% decrease of diastolic AP. The negative chronotropic effect of N exceeded that of PP. The stable effect, t. e. the effect that lasted continuously over 6 months, was seen in less that half the patients treated for a year. Therefore, N is an effective, comparatively safe and long-acting beta-blocker. As for its efficacy, it does not yield to PP or PS and compares very favourably with D. The drug can successfully be used in long-term treatment of arterial hypertension.
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D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D004359:Drug Therapy, Combination; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009248:Nadolol / Q000009:adverse effects / Q000627:therapeutic use*; D010352:Patient Dropouts; D011224:Prazosin / Q000009:adverse effects / Q000627:therapeutic use*; D011433:Propranolol / Q000009:adverse effects / Q000627:therapeutic use*; D012074:Remission Induction; D013997:Time Factors; D014586:USSR
D006852:Hydrochlorothiazide; D009248:Nadolol; D011433:Propranolol; D011224:Prazosin
Rezul'taty sravnitel'nogo izucheniia nadolola, propranolola, prazosina i gidrokhlortiazida u bol'nykh arterial'noĭ gipertonieĭ pri 12-mesiachnom lechenii po stupenchatoĭ skheme (kooperativnoe issledovanie). Rabochaia gruppa KIPPAG--II. Soobshchenie II: rezul'taty kombinirovannoĭ terapii. Pobochnye deĭstviia. Prichiny vybytiia. Zakliuchenie.