Atenolol and Chlorthalidone for Hypertension
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Atenolol and Chlorthalidone for Hypertension They appear to be most effective in combination therapy
19 black Jamaican hypertensive patients (14 men and 5 women), mean age 45.6 (range 30-60) years, all with diastolic BP > 95mm Hg participated in this double-blind study. After a 4-week placebo run-in period they were randomly allocated to atenolol 100 mg/day plus placebp or chlorthalidone 25 mg/day plus placebo. After 4 weeks, treatments were crossed over. Finally, all patients received the 2 drugs in combination therapy for 4 weeks.
After 4 weeks' placebo, the mean BP reading was 169/111mm Hg and heart rate (HR) was 75.5 beats/min. Mean systolic BP was 167mm Hg (NS), diastolic BP was 105mm Hg (p < 0.05 compared with entry diastolic BP) and HR was 68.7 beats/min (p < 0.05) after 4 weeks' atenolol therapy. After 4 weeks' chlorthalidone therapy, BP had significantly (p < 0.01) decreased to 150/100mm Hg. When patients received combination therapy with atenolol and chlorthalidone significant (p < 0.Q1) falls in BP and HR were observed; after 4 weeks the mean BP was 141/194mm Hg and HR was 66 .. 2 beats/min.
No patient withdrew because of side effects. The main side effects included cold extremities, tiredness, dizziness and effort dyspnoea. 15 patients on atenolol, 6 on chlorthalidone and 13 on combination therapy reported adverse effects. Patients on chlorthalidone showed a significant (p < 0.05) fall in serum potassium levels. Combination therapy was associated with a significant (p < 0.05) fall in serum potassium levels and uric acid significantly (p < 0.05) increased. Severe hypokalaemia (serum potassium levels < 3 mEq/L) was observed in 2 patients on chlorthalidone, and in 2 patients receiving combination therapy. Grell, GAC.; Forrester, TE and Alleyne, GAO: Southern Medical Journal 77: 1524-1528(Dec 1984)
0156-2703/85/0209-0013/0$01.00/0 ADIS Press INPHARMA 9 Feb 1985 13
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