Antihypertensive actions of diuretics. Comparative study of an aldosterone antagonist and a thiazide, alone and together

Abstract

Hydrochlorothiazide in a daily dose of 150 mg and spironolactone in a daily dose of 400 mg (100 mg of the currently available preparation) had equivalent antihypertensive effects-reducing basal blood pressure, decreasing the pressor response to levarterenol bitartrate (norepinephrine) and angiotensin amide, and increasing the depressor response to a ganglion-blocking agent, trimethaphan camsy-late-in a double-blind study of 11 hypertensive patients. The 2 diuretics, when given together, appear to act independently and additively in their antihypertensive effects. Serum K level, lowered by hydrochlorothiazide, was in the normal range during administration of spironolactone alone or in combination with hydrochlorothiazide. Spironolactone can thus be a useful substitute for a benzothiadiazine derivative in the treatment of hypertension. The administration of a combination of these diuretics, a thiazide and an aldosterone antagonist, can render hypertension more readily manageable.