spironolactone--althiazide-drug-combination and Hypertension

A multicenter study was performed in 919 hypertensive patients, 780 of whom could be evaluated. Patients in group I (n = 482) were treated with Aldactazine alone (altizide + spironolactone, 2 tablets per day). The other 298 patients (group II) were treated with 1 or 2 tablets per day of Aldactazine plus a conventional antihypertensive agent, e.g., a beta blocker, alpha-methyldopa or clonidine. After 45 days of treatment with Aldactazine alone, mean systolic and diastolic blood pressure (BP) decreased by 15 and 14%, respectively, vs baseline values. The addition of the other antihypertensive agent decreased BP further; however, the best results were obtained with the combination of Aldactazine and clonidine. With this combination, systolic and diastolic BP decreased by 16.6 and 18%, respectively, vs baseline. In terms of adverse effects, a few cases of gastrointestinal disturbances and orthostatic hypotension were reported.

Topics: Adrenergic beta-Antagonists; Adult; Aged; Aged, 80 and over; Benzothiadiazines; Clonidine; Diuretics; Drug Combinations; Drug Therapy, Combination; Female; Humans; Hypertension; Male; Methyldopa; Middle Aged; Multicenter Studies as Topic; Sodium Chloride Symporter Inhibitors; Spironolactone; Sulfonamides

A large-scale, open, nonrandomized, multicenter, 90-day study of the safety and efficacy of a thiazide diuretic and aldosterone antagonist combination (Aldactazine, 25 mg spironolactone and 15 mg altizide, 1/day) as monotherapy was performed in 946 patients with mild to moderate hypertension (diastolic blood pressure [BP] between 90 and 120 mm Hg). Adverse effects were assessed, and body weight, heart rate, serum potassium, creatinine and uric acid measurements were monitored. On day 45 of the study, BP was normalized (diastolic BP less than or equal to 90 mm Hg) in 72% of the patients. The dose was increased to 2 tablets per day in the patients whose BP did not reach normal levels. By the end of the study, BP was controlled in 83% of the patients. No significant changes were noted in body weight, heart rate or laboratory values; however, treatment had to be discontinued in 6 patients because of hypokalemia (n = 4) or elevated serum creatinine levels (n = 2). Serum uric acid levels were increased in 5.5% of patients. The rate of adverse effects, as reported by the patients, was low (5%). Thus, this study demonstrates that diuretics, especially the combination of a thiazide diuretic and aldosterone antagonist, remain a safe, effective and economical therapy for patients with mild to moderate hypertension.

Topics: Adolescent; Adult; Aged; Benzothiadiazines; Blood Pressure; Diuretics; Drug Combinations; Female; Humans; Hypertension; Male; Middle Aged; Multicenter Studies as Topic; Sodium Chloride Symporter Inhibitors; Spironolactone; Sulfonamides

The safety and efficacy of a thiazide/potassium-sparing diuretic and an angiotensin-converting enzyme inhibitor used concomitantly was evaluated in a large, multicenter study. Aldactazine was administered alone for 2 months, after which time captopril was added in those whose blood pressure had not normalized (332 patients). At the end of the 6-month study, control of blood pressure was achieved in 88% of the patients with one or the other regimen. No clinically significant changes were recorded for a number of biologic parameters. Specifically, there was 1 case of hyperkalemia (6 mmol/liter), a very low incidence of hypotension (1.6%), and a low rate of adverse effects. Therefore, such a combination could provide important therapeutic benefits in hypertensive patients.

Topics: Adolescent; Adult; Aged; Benzothiadiazines; Blood Pressure; Captopril; Diuretics; Drug Combinations; Drug Therapy, Combination; Female; Humans; Hypertension; Male; Middle Aged; Multicenter Studies as Topic; Sodium Chloride Symporter Inhibitors; Spironolactone; Sulfonamides

The effects of placebo and of a spironolactone-althiazide combination in the treatment of twenty-two Kenyan Africans with hypertension were assessed using a double-blind technique. After a 2-week medication-free period, patients were randomly allocated to placebo or active treatment for 6 weeks then crossing over to the alternative medication for a further 6 weeks, reverting to the original medication for a final 6 weeks. 100 mg spironolactone plus 60 mg althiazide per day was found to produce greater falls in blood pressure when compared with the placebo periods, sometimes significantly. No serious side-effects were reported. Electrolytes remained within normal limits.

Topics: Benzothiadiazines; Blood Pressure; Clinical Trials as Topic; Diuretics; Dose-Response Relationship, Drug; Double-Blind Method; Drug Combinations; Humans; Hypertension; Placebos; Sodium Chloride Symporter Inhibitors; Spironolactone; Sulfonamides

Topics: Benzothiadiazines; Diuretics; Drug Combinations; Heart Failure; Humans; Hypertension; Sodium Chloride Symporter Inhibitors; Spironolactone; Sulfonamides