| Title | Hydrochlorothiazide and Atenolol Combination Antihypertensive Therapy: Effects of Drug Initiation Order. | | Author(s) | Johnson JA, Gong Y, Bailey KR, Cooper-Dehoff RM, Chapman AB, Turner ST, Schwartz GL, Campbell K, Schmidt S, Beitelshees AL, Boerwinkle E, Gums JG | | Institution | [1] College of Pharmacy, University of Florida, Gainesville, Florida, USA [2] College of Medicine, University of Florida, Gainesville, Florida, USA [3] Center for Pharmacogenomics, University of Florida, Gainesville, Florida, USA. | | Source | Clin Pharmacol Ther 2009 Jul 1. | | Abstract | For combination antihypertensive therapy with thiazide diuretics and beta-blockers, the effect of the order of initiation of the drugs on the outcome has not been tested. Patients with uncomplicated hypertension were randomized to receive either hydrochlorothiazide (HCTZ) or atenolol monotherapy, followed by addition of the alternative drug. Blood pressure (BP) responses were evaluated by race and order of drug initiation. A total of 368 participants received combination therapy. Among the participants, blacks showed a greater BP-lowering effect than whites did with HCTZ monotherapy (-13.0/-7.4 mm Hg vs. -8.0/-4.2 mm Hg, P < 0.001) but a smaller BP-lowering effect than did whites with atenolol monotherapy (-1.1/-2.9 mm Hg vs. -9.9/-9.2 mm Hg, P < 0.0001). These differences were not evident during combination therapy. However, both groups showed greater response to HCTZ + atenolol than to atenolol + HCTZ (-19.1/-14.2 mm Hg vs. -15.6/-11.3 mm Hg, P < 0.0001). Despite optimal dosing of HCTZ + atenolol, only two-thirds of the participants achieved BP control. In HCTZ/atenolol combination antihypertensive therapy, the order in which the drugs are initiated affects total BP lowering during the first 4-6 months of therapy.Clinical Pharmacology & Therapeutics (2009); advance online publication 1 July 2009. doi:10.1038/clpt.2009.101. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19571804 |
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