COMPARISON OF PROPRANOLOL AND HYDROCHLOROTHIAZIDE FOR THE INITIAL TREATMENT OF HYPERTENSION .2. RESULTS OF LONG-TERM THERAPY

Abstract

Propranolol hydrochloride [P, a .beta.-blocker] or hydrochlorothiazide [HCT, a diuretic] were randomly allocated in a double-blind manner to 683 patients with initial diastolic BP [blood pressure] in the range of 95-114 mm Hg. Of this number, 394 entered the long-term treatment phase. During the subsequent 12 mo. of long-term treatment, HCT was more effective than P in controlling BP (mean reductions, -17.5/-13.1 mm Hg with HCT vs. -8.3/-11.3 with propranolol). After treatment with HCT, a greater percentage of patients achieved the goal diastolic BP of < 90 mm Hg (65.5% vs. 52.8% taking P). Also during treatment, fewer patients receiving HCT required termination than those receiving P; comparative dosage requirements were lower; additional titration during long-term treatment was required less often and BP remained lower after withdrawal of the active drugs. Biochemical abnormalities were greater with HCT. Although not statistically significant, the antihypertensive effects of HCT were greater in blacks than in whites. Whites, had a greater response to propranolol than blacks, although it was still less than the response of the whites to HCT.