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January 1, 1987The Journal of Clinical Pharmacology

The Effects of Bendroflumethiazide Added to Nifedipine in Patients With Hypertension

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Why the study?

Does bendroflumethiazide reduce supine blood pressure in patients with essential hypertension persistent on nifedipine?

Population

17 patients with essential hypertension who had persistent mild to moderate hypertension despite treatment…

Comparison

Bendroflumethiazide 5 mg added to background… vs Placebo added to background therapy of…

Design

RCT, randomized cross-over trial, double-blind

Authors

AZA.V. ZezulkaLeeds General InfirmaryJGJaswinder GillGuy's and St Thomas' NHS Foundation TrustDBDG BeeversPreventive Cardiology

Discussion

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Implication

Supports adding bendroflumethiazide to nifedipine for persistent hypertension; challenges theoretical arguments against combination efficacy.

Key Points

  • To determine whether adding the diuretic bendroflumethiazide to the calcium antagonist nifedipine provides additional blood pressure lowering in patients with persistent hypertension.
  • Conducted a double-blind, randomized cross-over trial in 17 patients with essential hypertension despite taking nifedipine slow-release tablets (20 mg bid).
  • Participants received bendroflumethiazide 5 mg either before (N = 8) or after (N = 9) placebo.
  • Supine blood pressure decreased significantly from baseline following bendroflumethiazide treatment in both arms (166/105 to 150/96 mm Hg, P < .01; 170/108 to 156/98 mm Hg, P < .01).
  • Combined treatment resulted in a reduction in serum potassium levels alongside an increase in serum uric acid concentrations.

Structured PICO

Does bendroflumethiazide reduce supine blood pressure in patients with essential hypertension persistent on nifedipine?

P
Population
17 patients with essential hypertension who had persistent mild to moderate hypertension despite treatment with nifedipine slow-release tablets 20 mg bid.
I
Intervention
Bendroflumethiazide 5 mg added to background therapy of nifedipine slow-release tablets 20 mg bid.
C
Comparator
Placebo added to background therapy of nifedipine slow-release tablets 20 mg bid (administered in a cross-over design).
O
Outcome
Supine blood pressuresurrogate

Adding bendroflumethiazide to nifedipine significantly reduces blood pressure in patients with persistent hypertension, challenging theoretic arguments that the combination is ineffective.

Cite This Study

Zezulka et al. (1987) studied this question.

synapsesocial.com/papers/6a87bd0d1fec1a0b3d26293dhttps://doi.org/10.1177/009127008702700106

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Controlled Trial of Nifedipine and Bendroflumethiazide in Hypertension1983 · 68 citations
  2. 2Does Nifedipine Reveal a Functional Abnormality of Arteriolar Smooth Muscle Cell in Essential Hypertension—The Effect of Altering Sodium Balance1985 · 24 citations
  3. 3Renal effects of acute calcium blockade with nifedipine in hypertensive patients receiving beta-adrenoceptor-blocking drugs1982 · 66 citations
  4. 4Are Surgery Blood Pressure Measurements Adequate to Evaluate the Efficacy of Antihypertensive Drugs?1984 · 9 citations
  5. 5Comparison of nifedipine (retard formulation) and mefruside in the treatment of mild to moderate hypertension—a prospective randomized double-blind crossover study in general practice1984 · 12 citations