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April 1, 1987The Journal of Clinical Pharmacology

Comparison of the Antihypertensive Efficacy and Adverse Reactions to Two Doses of Bendrofluazide and Hydrochlorothiazide and the Effect of Potassium Supplementation on the Hypotensive Action of Bendrofluazide: Substudies of the Medical Research Council's Trials of Treatment of Mild Hypertension: Medical Research Council Working Party

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Why the study?

Do lower doses of thiazide diuretics provide similar antihypertensive efficacy with fewer adverse reactions compared to higher doses in patients with hypertension?

Population

1,185 patients, comprising 484 patients with mild hypertension and 701 elderly patients with hypertension

Comparison

Bendrofluazide 5 mg vs 10 mg daily in the mild… vs Higher vs lower doses of the respective diuretic…

Design

RCT

Follow-up

35 +/- 17 months (Study 1) and 10 +/- 7 months (Study 2)

Authors

GGGillian GreenbergChildren's Hospital of Michigan

Discussion

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Implication

Supports lower thiazide doses for hypertension; confirms efficacy plateau with dose-dependent adverse effects.

Structured PICO

Do lower doses of thiazide diuretics provide similar antihypertensive efficacy with fewer adverse reactions compared to higher doses in patients with hypertension?

P
Population
1,185 patients, comprising 484 patients with mild hypertension and 701 elderly patients with hypertension
I
Intervention
Bendrofluazide 5 mg vs 10 mg daily (with or without potassium chloride 16.8 or 33.6 mmol) in the mild hypertension cohort; Hydrochlorothiazide 25 mg + amiloride 2.5 mg vs Hydrochlorothiazide 50 mg + amiloride 5 mg daily in the elderly cohort
C
Comparator
Higher vs lower doses of the respective diuretic regimens
O
Outcome
Blood pressure response, concentrations of biochemical variables, and incidence of subjective adverse reactionssurrogate

Lower doses of thiazide diuretics provide equivalent antihypertensive efficacy to higher doses but with fewer dose-related biochemical and subjective adverse reactions.

Cite This Study

Gillian Greenberg (1987) studied this question.

synapsesocial.com/papers/6a1f21fbe800cc4eef55326ahttps://doi.org/10.1002/j.1552-4604.1987.tb03012.x

Topics

Hypertension management
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Also Consider

Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Randomised study of six beta-blockers and a thiazide diuretic in essential hypertension1978 · 86 citations
  2. 2Dose response to chlorthalidone in patients with mild hypertension; Efficacy of a lower dose1978 · 108 citations