Hydrochlorothiazide/Triamterene and Atenolol Have Similar Efficacy In patients with mild hypertension

A multicentre randomised single-blind study compared the antihypertensive efficacy and tolerability of hydrochlorothiazide 25mgjtriamterene 50mg ('Dyazide'), 1 or 2 tablets daily (n = 118), with those of atenolol 1 OOmg daily (119) over 6 weeks in general practice patients with mild hypertension (diastolic BP 95-11 Omm Hg).

Supine and standing BP was significantly reduced in both treatment groups after 3 weeks and further reduced after 6 weeks. Supine BP decreased from 170/100 to 153/89 and from 173/101 to 154/ 88mm Hg in hydrochlorothiazidejtriamterene (n = 112) and atenolol (113) recipients, respectively. 33 and 26% of hydrochlorothiazidejtriamterene- and atenolol-treated patients, respectively, achieved a BP ~ 140/95mm Hg after 6 weeks. Supine HR was reduced by 2.2 and 11.1 beats/min, respectively. Nine and 8 hydrochlorothiazidejtriamterene and atenolol recipients, respectively, withdrew from the study because of adverse effects. 37 patients receiving hydrochlorothiazidejtriamterene reported 58 adverse reactions vs 43 atenolol recipients with 76, mostly CNS, adverse effects. Serum potassium levels were lower and uric acid levels higher in the diuretic-treated group, but more atenolol recipients had abnormally high serum potassium levels.

Thus, hydrochlorothiazidejtriamterene and atenolol appear to have comparable antihypertensive efficacy in patients with mild hypertension. Philip IG. Oueresh1 SM, Richards HH. Sharma SK. Wnght FGdeL. et al. Bnt1sh Journal of Clinical Practice 41 947-953. Oct 1987

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0156-2703/ 88j0305-0009j0$01.00/0 © AO/S Press INPHARMA"' 5 March 1988 9