This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

I. Results of Short-term Titration With Emphasis on Racial Differences in Response

Veterans Administration Cooperative Study Group on Antihypertensive Agents

JAMA. 1982;248(16):1996-2003.

Abstract
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 ±7.6 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 mm 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.

(JAMA 1982;248:1996-2003)

Author Affiliations
From the Cooperative Studies Program, Medical Research Service of the Veterans Administration, Hines, III.

Footnotes
Presented in part at the American Heart Association Scientific Session, Dallas, Nov 19, 1981.

Reprint requests to the Veterans Administration Medical Center (111), 1201 NW 16th St, Miami, FL 33125 (Barry J. Materson, MD).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Chromosome 2p Shows Significant Linkage to Antihypertensive Response in the British Genetics of Hypertension Study
Padmanabhan et al.
Hypertension 2006;47:603-608.
ABSTRACT | FULL TEXT  

Management of hypertension in ethnic minorities
Khan and Beevers
Heart 2005;91:1105-1109.
FULL TEXT  

Variability in Response to Antihypertensive Drug Treatment
Materson
Hypertension 2004;43:1166-1167.
FULL TEXT  

Systolic Blood Pressure, Diastolic Blood Pressure, and Pulse Pressure as Predictors of Risk for Congestive Heart Failure in the Framingham Heart Study
Haider et al.
ANN INTERN MED 2003;138:10-16.
ABSTRACT | FULL TEXT  

Ethnic differences in hypertension and blood pressure control in the UK
Lane and Lip
QJM 2001;94:391-396.
FULL TEXT  

Stalked by the Past: The Influence of Ethnicity on Health
Dimsdale
Psychosom. Med. 2000;62:161-170.
ABSTRACT | FULL TEXT  

The necessity for recognition and treatment of patients with "mild" hypertension
Frohlich
J Am Coll Cardiol 1999;34:1369-1377.
ABSTRACT | FULL TEXT  

The management of hypertensive disease in Black patients
Gibbs et al.
QJM 1999;92:187-192.
ABSTRACT | FULL TEXT  

Getting research findings into practice: When to act on the evidence
Sheldon et al.
BMJ 1998;317:139-142.
FULL TEXT  

Racial Differences in Epinephrine and ß2-Adrenergic Receptors
Mills et al.
Hypertension 1995;25:88-91.
ABSTRACT | FULL TEXT  

Selected Factors That Influence Responses to Antihypertensives: Choosing Therapy for the Uncomplicated Patient
Carter et al.
Arch Fam Med 1994;3:528-535.
ABSTRACT  

Reduction in Long-term Antihypertensive Medication Requirements: Effects of Weight Reduction by Dietary Intervention in Overweight Persons With Mild Hypertension
Davis et al.
Arch Intern Med 1993;153:1773-1782.
ABSTRACT  

Single-Drug Therapy for Hypertension in Men -- A Comparison of Six Antihypertensive Agents with Placebo
Materson et al.
NEJM 1993;328:914-921.
ABSTRACT | FULL TEXT  

Systolic Hypertension in the Elderly: Pathophysiology and Management
Mann
Arch Intern Med 1992;152:1977-1984.
ABSTRACT  

A Randomized Controlled Trial of the Effects of Three Antihypertensive Agents on Blood Pressure Control and Quality of Life in Older Women
Applegate et al.
Arch Intern Med 1991;151:1817-1823.
ABSTRACT  

Who Really Determines Your Patients' Prescriptions?
Moser et al.
JAMA 1991;265:498-500.
ABSTRACT  

Critique of the Clinical Importance of Diurectic-Induced Hypokalemia and Elevated Cholesterol Level
FREIS
Arch Intern Med 1989;149:2640-2648.
ABSTRACT  

Comparison of the Antihypertensive Effects of Betaxolol and Chlorthalidone as Monotherapy and in Combination
Burris et al.
Arch Intern Med 1989;149:2437-2441.
ABSTRACT  

Hypertension in Elderly Patients
Applegate
ANN INTERN MED 1989;110:901-915.
ABSTRACT  

Cigarette Smoking Interferes With Treatment of Hypertension
Materson et al.
Arch Intern Med 1988;148:2116-2119.
ABSTRACT  

Diuretics and Hypertension in Black Adults
Hawkins et al.
Arch Intern Med 1988;148:803-805.
ABSTRACT  

Ibuprofen and Antihypertensive Drugs
FUREY
ANN INTERN MED 1988;108:645-645.
ABSTRACT  

Diltiazem and Propranolol in Mild to Moderate Essential Hypertension as Monotherapy or with Hydrochlorothiazide
MASSIE et al.
ANN INTERN MED 1987;107:150-157.
ABSTRACT  

Hydrochlorothiazide With or Without Amiloride for Hypertension in the Elderly: A Dose-Titration Study
Myers
Arch Intern Med 1987;147:1026-1030.
ABSTRACT  

{beta}-Adrenergic Blocking Agents in the Treatment of Hypertension: Choices Based on Pharmacological Properties and Patient Characteristics
Wallin and Shah
Arch Intern Med 1987;147:654-659.
ABSTRACT  

Clinical Experience With Timolol Maleate Monotherapy of Hypertension
Bannon et al.
Arch Intern Med 1986;146:654-657.
ABSTRACT  

Antihypertensive Therapy and Lipids: Evidence, Mechanisms, and Implications
Weinberger
Arch Intern Med 1985;145:1102-1105.
ABSTRACT  

Mild Hypertension
Burris
Arch Intern Med 1983;143:2015-2015.
ABSTRACT  

Metabolic Consequences of Antihypertensive Therapy
FLAMENBAUM
ANN INTERN MED 1983;98:875-880.
ABSTRACT