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Diuretics and Hypertension in Black Adults

David W. Hawkins, PharmD; Merwin R. Dieckmann, MD; Ronnie D. Horner, PhD
Arch Intern Med. 1988;148(4):803-805. doi:10.1001/archinte.1988.00380040043009.
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• 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)


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