Key result
Adding methyldopa to thiazide diuretics blunts renin rise and further lowers BP.
Why the study?
Does the addition of methyldopa to a diuretic improve blood pressure and blunt the rise in plasma renin activity in hypertensive subjects?
Does the addition of methyldopa to a diuretic improve blood pressure and blunt the rise in plasma renin activity in hypertensive subjects?
The addition of methyldopa to thiazide diuretic therapy blunts the diuretic-induced rise in plasma renin activity and further lowers blood pressure in hypertensive patients.
May support combined use for BP control in hypertension; hypothesis-generating and requires RCT confirmation before practice change.
The rise in plasma renin activity (PRA) that accompanies thiazide diuretic therapy of hypertension may interfere with therapeutic effectiveness and contribute to hypokalemia. In an attempt to provide a basis for the previously empiric use of antihypertensive drugs, 20 hypertensive subjects were given a diuretic alone for three weeks and a diuretic plus methylodopa, which lowers PRA, for three weeks. The thiazide-induced rise in PRA was blunted by the methyldopa, while bl-od pressure fell even more and renal function was well maintained. The combination of a renin-lowering drug and a diuretic is rational and effective therapy for hypertension.
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Norman M. Kaplan (1975) studied Hypertension (n=20). Diuretic plus methyldopa vs. Diuretic alone was evaluated on Plasma renin activity (PRA), blood pressure, and renal function. Adding methyldopa to thiazide diuretic therapy for 3 weeks blunted the thiazide-induced rise in plasma renin activity and further lowered blood pressure in 20 hypertensive subjects.