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David W. Hawkins, PharmD; Merwin R. Dieckmann, MD; Ronnie D. Horner, PhD

Arch Intern Med. 1988;148(4):803-805.

Abstract
• 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)

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).

Footnotes
Accepted for publication Dec 28, 1987.

Read before the Second International Interdisciplinary Conference on Hypertension in Blacks, Atlanta, March 6, 1987.

Reprint requests to Clinical Pharmacy Program, CN 137, Medical College of Georgia, Augusta, GA 30912 (Dr Hawkins).

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