What question did this study set out to answer?

To determine whether co-administering a beta-blocker alters the flat dose-response curve and metabolic side effects of thiazide diuretics in essential hypertension.

May 14, 1983BMJOpen Access

Lack of effect of beta-blocker on flat dose response to thiazide in hypertension: efficacy of low dose thiazide combined with beta-blocker.

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Why the study?

Does increasing the dose of hydrochlorothiazide when combined with acebutolol improve blood pressure reduction in patients with essential hypertension?

Population

Patients with essential hypertension

Comparison

Hydrochlorothiazide combined with acebutolol 400… vs Different doses of hydrochlorothiazide combined…

Design

RCT, randomised crossover

Authors

GMG. A. MacGregorQueen Mary University of London RBR A BanksUniversity College Hospital NMNirmala D. MarkanduGeneral / Preventive / Lipids

Discussion

Member takes

Implication

Low-dose hydrochlorothiazide with acebutolol achieves equivalent blood pressure reduction; confirms flat dose-response persists while higher doses increase metabolic harm.

Key Points

To determine whether co-administering a beta-blocker alters the flat dose-response curve and metabolic side effects of thiazide diuretics in essential hypertension.
Conducted two randomized crossover studies in patients with essential hypertension.
Evaluated the effects of 12.5 mg, 25 mg, and 50 mg of hydrochlorothiazide combined with 400 mg of acebutolol.
Mean supine blood pressure fell by approximately 15% across all hydrochlorothiazide doses (12.5 mg, 25 mg, and 50 mg) when combined with acebutolol.
Higher doses of hydrochlorothiazide produced escalating adverse metabolic consequences without providing any additional blood pressure reduction.

Structured PICO

Does increasing the dose of hydrochlorothiazide when combined with acebutolol improve blood pressure reduction in patients with essential hypertension?

Population

Patients with essential hypertension

Intervention

Hydrochlorothiazide (12.5 mg, 25 mg, or 50 mg) combined with acebutolol 400 mg

Comparator

Different doses of hydrochlorothiazide (12.5 mg, 25 mg, 50 mg) combined with acebutolol 400 mg (crossover design)

Outcome

Mean fall in supine blood pressuresurrogate

Combining a beta-blocker with low-dose hydrochlorothiazide (12.5 mg) is as effective for blood pressure reduction as higher doses, while avoiding the increased metabolic adverse effects associated with higher diuretic doses.

Limitations

The study did not define the minimum dose of diuretic

Cite This Study

MacGregor et al. (1983) studied this question.

synapsesocial.com/papers/6a712b263ce530166bc306a4 https://doi.org/10.1136/bmj.286.6377.1535

Topics

Hypertension management

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Implication

Low-dose hydrochlorothiazide with acebutolol achieves equivalent blood pressure reduction; confirms flat dose-response persists while higher doses increase metabolic harm.

Lack of effect of beta-blocker on flat dose response to thiazide in hypertension: efficacy of low dose thiazide combined with beta-blocker.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Lack of effect of beta-blocker on flat dose response to thiazide in hypertension: efficacy of low dose thiazide combined with beta-blocker.

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

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