A double-blind, randomized, controlled trial comparing pinacidil to hydralazine in essential hypertension.
Pinacidil is a direct vasodilator with good absorption, a half-life of 2 to 4 hours, and side effects similar to those of other vasodilators. We hypothesized that controlled-release pinacidil would be comparable to or better than hydralazine for blood pressure control and side effects. A double-blind, randomized trial comparing pinacidil with hydralazine when combined with hydrochlorothiazide or propranolol to control side effects or the diastolic blood pressure was performed. Pinacidil decreased systolic and diastolic blood pressure from 156/100 mm Hg to 132/81 mm Hg. The increase in heart rate and weight with both drugs was controlled with the additional drugs. There was 1/17 successes on monotherapy with both drugs. When combined with other drugs there were 15/18 successes with hydralazine and 16/20 successes with pinacidil. Side effects were typical of vasodilators. Both drugs acutely increased plasma norepinephrine and epinephrine during chronic therapy.
Byyny
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Nies
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LoVerde
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Mitchell
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D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002986:Clinical Trials as Topic; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D004837:Epinephrine / Q000097:blood; D005260:Female; D006146:Guanidines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006830:Hydralazine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D020110:Pinacidil; D011433:Propranolol / Q000627:therapeutic use; D011897:Random Allocation; D012083:Renin / Q000097:blood
D003692:Delayed-Action Preparations; D006146:Guanidines; D006852:Hydrochlorothiazide; D006830:Hydralazine; D020110:Pinacidil; D011433:Propranolol; D012083:Renin; D009638:Norepinephrine; D004837:Epinephrine