Why the study?
Does hydrochlorothiazide reduce blood pressure in hypertensive patients receiving nicardipine?
Does hydrochlorothiazide reduce blood pressure in hypertensive patients receiving nicardipine?
Low doses of hydrochlorothiazide provide modest antihypertensive effects when added to a calcium channel blocker, but higher doses (25-50 mg) offer no additional blood pressure lowering while causing significant metabolic side effects.
Low-dose hydrochlorothiazide modestly lowers BP added to nicardipine; challenges higher doses by confirming no extra reduction yet dose-dependent metabolic effects.
Seven hypertensive patients receiving the dihydropyridine calcium channel blocking agent nicardipine were given placebo, 6.25, 12.5, 25 and 50 mg hydrochlorothiazide (HCTZ) in a randomized crossover design. Blood pressure (BP) decreased by about 7/3 mmHg irregardless of dose. In contrast, potassium, glucose and uric acid increased in a dose-dependent fashion. The hypokalemic and hyperglycemic responses at 50 mg were larger than usually seen with HCTZ. Low doses of HCTZ provided a modest antihypertensive effect, but 25 and 50 mg of HCTZ were no more effective in lowering BP and gave unusually large metabolic side effects when combined with a calcium channel blocker.
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Ziegler et al. (1988) studied this question.
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