Chlorthalidone Plus Reserpine Versus Hydrochlorothiazide Plus Reserpine in a Stepped‐Care Approach to the Treatment of Essential Hypertension

The efficacy of thiazide-like chlorthalidone, 50 mg, plus reserpine, 0.25 mg, was compared with that of hydrochlorothiazide, 50 mg, plus reserpine, 0.125 mg, in a six-week double-blind study of 57 patients with essential hypertension unresponsive to diet control and diuretic (step 1) therapy. An average decrease in diastolic pressure of 17.0 mm Hg was attained at the end of week 6 by the chlorthalidone/reserpine group; the average drop in the hydrochlorothiazide/reserpine group was 18.6 mm Hg. Both treatment groups displayed greater blood pressure control each week than the preceding week; and, at the end of week 6, both groups attained control of at least 5 mm Hg below the diastolic goal pressure of 90 mm Hg. The chlorthalidone/reserpine-treated group required fewer titrations than the hydrochlorothiazide/reserpine-treated group. There were no reports of frequent or severe side effects with either drug.