Readjustment of antihypertensive treatment in patients with unsatisfactory blood pressure control.
Blood pressure response in 75 patients with primary hypertension to a readjusted treatment regimen was studied. The patients were given 13 antihypertensive drugs in 18 combinations. Since they all suffered from severe hypertension, the first choice was a combination of beta-blocker and diuretic. A vasodilator (hydralazine or prazosin) was added when necessary to control blood pressure. During a three-year follow-up study the patients' systolic and diastolic blood pressures were significantly lowered, from 174 (SD, +/- 25)/113 (SD, +/- 12) to 154 (SD, +/- 19)/98 (SD, +/- 8) mmHg. There was a significant decrease in serum creatinine levels, but body weight, heart volume, and serum lipid levels remained unchanged. In 62 (83%) patients diastolic blood pressure was reduced below 100 mmHg, and in 13 (17%) it remained above 100 mmHg. During the three-year follow-up study no patients with a diastolic blood pressure below 100 mmHg had a stroke, while three patients with a diastolic blood pressure above 100 mmHg did. This study demonstrates that heterogeneous drug combinations might fail to adequately control blood pressure and reducing the number of combinations might improve control.
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
D000959:Antihypertensive Agents