April 1988

Diuretics and Hypertension in Black Adults

Author Affiliations

From the College of Pharmacy, University of Georgia, Athens, and the Medical College of Georgia, Augusta (Dr Hawkins); and the Department of Family Medicine, East Carolina University School of Medicine, Greenville, NC (Drs Dieckmann and Horner).

Arch Intern Med. 1988;148(4):803-805. doi:10.1001/archinte.1988.00380040043009

• A randomized controlled, single-blind trial was conducted to compare the effectiveness of a high-dose diuretic with a combination of a diuretic and metoprolol in black adults with hypertension. All subjects were first treated with 50 mg/d of hydrochlorothiazide for four weeks. Only subjects with a diastolic blood pressure of 95 mm Hg or higher at the end of this four-week period entered the randomized trial. We hypothesized that black patients with uncontrolled hypertension and low plasma renin activity on usual-dose hydrochlorothiazide therapy (ie, 50 mg/d) would respond better to higher doses of hydrochlorothiazide (ie, 100 to 150 mg/d) than to a usual-dose diuretic and metoprolol. Diuretic-metoprolol combination therapy was significantly more effective than high-dose diuretic therapy regardless of plasma renin status.

(Arch Intern Med 1988;148:803-805)