Effects of reduction in dose and discontinuation of hydrochlorothiazide in patients with controlled essential hypertension.
We studied the effects of a reduction in dose of hydrochlorothiazide from 50 to 25 mg/d, and its discontinuation for up to 22 months in 36 well-controlled hypertensive patients. Hydrochlorothiazide was discontinued if the diastolic blood pressure remained less than or equal to 94 mm Hg after a 6-month period on the lower dose of hydrochlorothiazide. No other changes were made in medications or diet. Sitting systolic blood pressure rose from 135 +/- 15 mm Hg to 140 +/- 14 mm Hg on reduction of the hydrochlorothiazide dose and rose still further to 145 +/- 20 mm Hg on discontinuation. Even greater increases in standing blood pressure were observed. There were no significant effects on the diastolic blood pressure with reduction of dose or discontinuation of hydrochlorothiazide. A significant decrease in the serum uric acid and a rise in serum potassium occurred. There were no changes in serum glucose or lipids on reduction in the dose of hydrochlorothiazide; whereas, with discontinuation, the serum lipids and hemoglobin A1C fell significantly. These results suggest that the benefits of a reduced dose of hydrochlorothiazide may not be as great as considered heretofore.
Kochar
M S
MS
Hypertension Section, Zablocki Veterans Affairs Medical Center, Milwaukee, WI 53295.
Landry
K M
KM
Ristow
S M
SM
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D006339:Heart Rate; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000627:therapeutic use*; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D011187:Posture; D011188:Potassium / Q000097:blood; D011446:Prospective Studies; D013997:Time Factors; D014527:Uric Acid / Q000097:blood
D001786:Blood Glucose; D008055:Lipids; D006852:Hydrochlorothiazide; D014527:Uric Acid; D011188:Potassium