Comparative study of the efficacy and tolerability of hydroflumethiazide versus propranolol in Africans with mild to moderate hypertension.
Sixty patients with Diastolic Blood Pressure (DBP) of 100-110mmHg matched for age, sex and Bp levels were randomly assigned to propranolol 80mg daily or Hydroflumethiazide (HFM) 50mg daily. HFM causes a significant reduction in systolic blood pressure (SBP) and DBP within 4 weeks compared both with baseline and propranolol (SBP 143.7 +/- 12.3 vs 158.1 +/- 10.9mmHg, P < 0.05; DBP 92.0 +/- 4.5 vs 102.4 +/- 5.1mmHg, P < 0.05), (SBP 143.7 +/- 12.2 vs 152 +/- 11.0mmHg P < 0.05; DBP 92.0 +/- 4.5 vs 101.1 +/- 6.1mmHg, P < 0.05), respectively. Propranolol produced no significant difference from the baseline at 4 weeks (SBP 152.0 +/- H.0 vs 154.1 +/- 11.5mmHg NS; DBP 101.1 +/- 6.1 vs 102.2 +/- 5.6mmHg, NS). Reduction in BP by HFM was maintained after 8 and 12 weeks with further reduction but which did not achieve statistical significance. Increased dose of propranolol (160mg daily) after 4 weeks caused significant reduction in BP by 8 week (SBP 146.8 +/- 11.8 vs 152.0 +/- 11.0mmHg, P < 0.05; DBP 95.9 +/- 4.4 vs 101.1 +/- 6.1mmHg P < 0.05), which was maintained upto 12 weeks. The values however remained higher than in the HFM group. More patients in the HFM group achieved target BP (< 140/90), SBP 53.8% vs 29.6% P < 0.05, DBP 69.2% vs 14.8% P < 0.01. Incidence of side effects was similar and will be discussed. Thiazides are superior to B'blockers as initial monotherapy in black hypertensives.
Ogola
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Department of Medicine, College of Health Sciences, University of Nairobi, Kenya.
Yonga
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D000328:Adult; D000368:Aged; D044383:Black People; D001794:Blood Pressure / Q000187:drug effects; D003971:Diastole; D005260:Female; D006801:Humans; D006857:Hydroflumethiazide / Q000494:pharmacology / Q000627:therapeutic use*; D006973:Hypertension / Q000145:classification / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D007630:Kenya; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D011433:Propranolol / Q000494:pharmacology / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors
D006857:Hydroflumethiazide; D011433:Propranolol