Comparison of propranolol and hydrochlorothiazide for thr initial treatment of hypertension. I. Results of short-term titration with emphasis on racial differences in response. Veterans Administration Cooperative Study Group on Antihypertensive agents
We compared hydrochlorothiazide and propranolol hydrochloride for
monotherapy of hypertension by a double-blind study of 683 men who were
titrated to less than 90 mm Hg diastolic BP or to 640 mg of propranolol or
200 mg of hydrochlorothiazide. Propranolol reduced systolic BP from 146.0
+/- 14.4 (SD) to 134.8 +/- 16.3 mm Hg and diastolic BP from 101.6 +/- 4.6
to 90.5 +/- 7.5 mm Hg. Hydrochlorothiazide lowered both systolic BP more
effectively from 146.5 +/- 15.8 to 128.8 +/- 12.2 mm Hg and diastolic BP
from 101.3 +/- 4.5 to 89.4 +/- 6.5 mm Hg. In blacks, hydrochlorothiazide
lowered systolic BP 20.3 +/- 14.3 mm Hg v 8.2 +/- 12.2 mm Hg for
propranolol; hydrochlorothiazide reduced diastolic BP 13.0 +/- 7.0 mm Hg v
9.5 +/- 7.0 for propranolol. In whites, the systolic BP reductions were
15.3 +/- 12.0 mm Hg for hydrochlorothiazide v 13.2 +/- 13.1 mmn Hg for
propranolol; diastolic BPs were 10.9 +/- 5.7 mm Hg for hydrochlorothiazide
and 12.6 +/- 6.6 mm Hg for propranolol. In blacks treated with
hydrochlorothiazide, 71.3% achieved diastolic BP of less than 90 mm Hg, v
53.5% with propranolol. There was no racial difference in dose response to
propranolol, but blacks required much less hydrochlorothiazide to achieve
control. We conclude that in this short-term study propranolol was as
efficacious as hydrochlorothiazide in whites, but the latter was more
effective than propranolol in blacks.
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