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The treatment of high blood pressure in the elderly: a multi-centre evaluation of a fixed combination of metoprolol and hydrochlorothiazide ("Co-Betaloc") in general practice.

Goodfellow RM, Westberg B.

A post-marketing surveillance programme was carried out in general practice to evaluate the efficacy and tolerability of a fixed-dose combination of 100 mg metoprolol and 12.5 mg hydrochlorothiazide in the treatment of mild to moderate hypertension, with particular reference to elderly patients. Patients received a single daily dose over a period of 3 months. The results of the analysis of data from 1446 patients showed that, although the initial blood pressure was higher in the elderly, both the systolic and diastolic pressures were reduced by the same degree after 3-months' treatment, regardless of age. The incidence of side-effects was similar in all age groups, although a higher proportion of these side-effects led to treatment withdrawal in the elderly, possibly reflecting an increasing overall intolerance to drugs with age. The results suggest that treatment with the metoprolol/hydrochlorothiazide combination is effective and well tolerated in the majority of hypertensive patients, irrespective of age or previous antihypertensive therapy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7307545&dopt=Abstract hydrochlorothiazide Microzide



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Compared effects of indapamide, hydrochlorothiazide and chlorthalidone on electrical and mechanical activities in vascular smooth muscle.

Mironneau J, Savineau JP, Mironneau C.

The effects of indapamide, hydrochlorothiazide and chlorthalidone were studied on isometric contractions, calcium contractures (in depolarized preparations) and membrane potentials in isolated longitudinal strips from rat portal veins. Indapamide inhibited all three responses more potently than did current diuretics. The effects of hydrochlorothiazide and chlorthalidone appeared at concentrations at which indapamide reduced electrical and mechanical activity by more than 50%. These results confirmed that the depressing action of indapamide on vascular smooth muscle was exerted through a reduction in the transmembrane clacium influx.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7318900&dopt=Abstract hydrochlorothiazide Microzide



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The use of acebutolol with hydrochlorothiazide in hypertension.

Darmadji T, Pikir BS, Yogiarto M, Saleh M.

The antihypertensive effect of acebutolol 400 mg and hydrochlorothiazide 25 mg in combination have been assessed in 22 patients with mild, moderate and severe hypertension. In the supine position, blood pressure went down from an average of 190/116 mm Hg to 147/91 mm Hg after treatment, while in the standing position, blood pressure went down from an average of 188/117 mm Hg to 143/94 mm Hg. Age, sex and duration of hypertension have no significant influence upon the antihypertensive effect of this combination. Good results were obtained in 68% of the patients, fair results in 23% and poor results in another 9%. Compared with the use of acebutolol alone, its combination with hydrochlorothiazide showed better results. In mild hypertension good results increased from 75% after acebutolol only to 100% after this combination. In moderate hypertension the percentage of good results increases from 47% to 60% and in severe hypertension good results increased from 50% to 67%. Increase of decrease in heart rate had no relation to the antihypertensive effect of this combination.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7344597&dopt=Abstract hydrochlorothiazide Microzide



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[Compared metabolic effects of phosphorus or hydrochlorothiazide therapy in hypercalciuric stone-formers (author's transl)]

[Article in French]

Dard S, Ulmann A.

The hypocalciuric effect of phosphorus or hydrochlorothiazide therapy was evaluated in 26 hypercalciuric stone-formers after 2 to 4 months and 8 to 12 months treatment. After 2 to 4 months, a significant decrease of the urinary calcium to creatinine ratio was noted only in a group of 7 patients receiving phosphorus supplementation (1500 mg/day). The decrease was transient however, since in 5 of these patients, the calcium to creatinine ratio was found to be at pretreatment levels when the patients were reinvestigated after 8 to 12 months on phosphorus. In contrast, in 8 patients receiving hydrochlorothiazide (50 mg/day) during 8 to 12 months, this ratio was significantly lower (P less than 0.01) than before treatment. A group of patients maintained on high water intake alone for 8 to 12 months served as a control and no modification in calcium excretion was observed. This study indicates that long-term treatment with hydrochlorothiazide is more efficient in lowering urinary calcium excretion than phosphorus therapy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7345375&dopt=Abstract hydrochlorothiazide Microzide



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Responses to hydrochlorothiazide and acetazolamide in patients with calcium stones. Evidence suggesting a defect in renal tubular function.

Sutton RA, Walker VR.

Urinary excretion of sodium, calcium, and magnesium has been measured after single oral doses of hydrochlorothiazide (100 mg) and acetazolamide (500 mg) in unselected patients with calcareous renal stone formation and in normal control subjects. With hydrochlorothiazide, 36 stone formers had significantly greater increments in sodium (P less than 0.01), calcium (P less than 0.05), and magnesium (P less than 0.05) excretion than 20 normal subjects. With acetazolamide, 13 stone formers had a smaller increment in sodium excretion (P less than 0.05) than 10 normal subjects. The abnormal responses to both diuretics were most marked in the patients with hypercalciuria during fasting. These data suggest that the tubular handling of sodium, magnesium, and calcium may be abnormal in patients with calcareous renal stones and are consistent with the presence of a defect in proximal-tubular reabsorption of fluid and electrolytes that may be partly offset by increased reabsorption in the distal nephron.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7354777&dopt=Abstract hydrochlorothiazide Microzide