Hypertension therapy--an update.

Six black hypertensive patients responded favorably to treatment with verapamil hydrochloride (Isoptin). The patients were participants in a larger study.

Labetalol as monotherapy in hypertensive black patients.

The antihypertensive effect of labetalol was evaluated in 18 adult black patients with mild to moderate essential hypertension previously controlled with a combination of a diuretic and a beta blocker. After a 4-week washout period, standing blood pressure had increased from 138 +/- 2.2/85 +/- 1.5 mmHg, (mean +/- SEM) to 154 +/- 1.9/100 +/- 0.6 mmHg. Labetalol was then titrated to a maximum of 600 mg BID to obtain a standing diastolic blood pressure of less than or equal to 90 mmHg and/or a decrease of greater than or equal to 10 mmHg from baseline (end of washout period). By the end of the labetalol titration period, standing blood pressure had decreased to 140 +/- 2.0/84 +/- 1.5 (p less than 0.01). Following a 2-week maintenance period, standing blood pressure was 136 +/- 1.6/80 +/- 1.5 mmHg (NS vs. titration). Labetalol therapy was well tolerated and reduced diastolic blood pressure to less than or equal to 90 mmHg in 17 of 18 patients, 13 of whom required dosages less than or equal to 300 mg BID. The average reduction in standing heart rate while on labetalol was 4 bpm (p less than 0.01). Side effects were limited to skin rash in one patient and possible mild urinary retention in another. These data indicate that labetalol is an effective antihypertensive for black patients with mild to moderate essential hypertension.

Antihypertensive effect of oral timolol maleate and hydrochlorothiazide once daily compared with hydrochlorothiazide once daily.

The efficacy and safety of timolol maleate combined with hydrochlorothiazide given once daily compared with hydrochlorothiazide given once daily to patients with hypertension was investigated in a double-blind, randomized study. Patients with uncomplicated, mild to moderate hypertension were admitted to the study. Ten patients received two tablets once daily of timolol maleate 10 mg and hydrochlorothiazide 25 mg (T/H). Nine patients received hydrochlorothiazide 25 mg (HCTZ). Blood pressure and pulse rate measurements and laboratory tests were performed after a six-week placebo baseline period and throughout the 12-week study. Mean supine systolic blood pressure decreased by 21-35 mm Hg for the T/H group and by 10-24 mm Hg for the HCTZ group. Mean supine diastolic blood pressure decreased by 15-22 mm Hg for the T/H group and by 10-13 mm Hg for the HCTZ group. Changes observed in the laboratory variables were not statistically significant between the two treatment groups. One patient in each group had an adverse experience considered unrelated to the drug, and no patient had to discontinue the drug therapy because of an adverse reaction. Although both drug regimens effectively and safely treated uncomplicated mild to moderate hypertension, the timolol maleate and hydrochlorothiazide combination had a greater antihypertensive effect.