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O. Bryan Holland, MD; Celso E. Gomez-Sanchez, MD; LaVon Kuhnert, RN; Carol Poindexter, RN; Charles Y. C. Pak, MD

Arch Intern Med. 1979;139(9):1015-1021.

Abstract
Furosemide and hydrochlorothiazide were compared for treatment of black patients with mild to moderate hypertension in a randomized, open-label, crossover study design. Hydrochlorothiazide produced a significantly greater fall in mean arterial (24.7 vs 16.0 mm Hg, P <.01) and diastolic (17.3 vs 10.1 mm Hg, P <.01) blood pressure (BP) in 16 patients. Addition of methyldopa in nine patients produced a significantly greater fall in mean arterial (38.8 vs 31.9 mm Hg, P <.05) and diastolic (28.9 vs 23.4 mm Hg, P <.05) BP with hydrochlorothiazide vs furosemide. Renin status was categorized before and after treatment. Patients with low and normal renin activity were equally responsive to both diuretics. Hydrochlorothiazide caused a greater reduction in plasma potassium (0.26 mEq/L). Serum parathyroid hormone was not chronically elevated with furosemide. In this study, hydrochlorothiazide was more effective than furosemide for treatment of mild to moderate hypertension in black patients; renin classification did not predict diuretic responsiveness.

(Arch Intern Med 139:1015-1021, 1979)

Author Affiliations
From the Department of Internal Medicine, University of Texas Health Science Center, Dallas.

Footnotes
Accepted for publication Feb 12, 1979.

Reprint requests to Department of Internal Medicine, 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr Holland).

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