Summary
The antihypertensive efficacy of a new long-lasting vasodilator, cadralazine, and the diuretic chlorthalidone have been compared in hypertensive patients receiving concurrent treatment with atenolol. After a 4-week run-in period with atenolol alone 100 mg/day, two groups of 10 patients whose diastolic blood pressure exceeded 100 mm Hg were given for a period of 65 days either cadralazine 15 mg/day or chlorthalidone 25 mg/day, according to a randomized, double-blind, between-patients design. Compared to atenolol alone, both cadralazine and chlorthalidone induced a statistically and clinically significant decrease in blood pressure. The antihypertensive effect did not differ significantly between groups. Good compensation of the atenolol-induced decrease in heart rate was obtained with cadralazine, whereas during atenolol + chlorthalidone treatment at times the standing heart rate was significantly lower than during treatment with atenolol + cadralazine. Side-effects, many of which were already present during atenolol treatment, occurred with a similar frequency in both groups. It is concluded that atenolol + cadralazine and atenolol + chlorthalidone are equally well tolerated, acceptable and effective in the treatment of hypertension, but that further studies are warranted to explore the potential haemodynamic advantages of the cadralazine + atenolol combination.
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References
Parravicini F, Scarpitta G, Dorigotti L, Pifferi G (1979) Derivati della 3-idrazinopiridazina. Farmaco [Sci] 34: 299–310
Semeraro C, Dorigotti L, Banfi C, Carpi C (1981) Pharmacological studies on cadralazine: a new antihypertensive vasodilator drug. J Cardiovasc Pharmacol 3: 455–467
Catalano M, Parini J, Libretti A (1983) Cadralazine (ISF 2469) dose-related antihypertensive activity after single oral administration to patients. Eur J Clin Pharmacol 24: 157–161
Lavezzaro GC, Gastaldo D, Noussan P, Bensoni M, Parini J, Angelino PF (1981) The effects of cadralazine (ISF 2469) on water-salt equilibrium and essential arterial hypertension. Minerva Cardioangiol 29: 527–534
Semplicini A, Pessina AC, Caregaro L, Gatta A, Samà B, Rossi GP, Dal Palù C (1983) Blood pressure, body fluids and renal tubular handling of sodium during cadralazine plus atenolol treatment in essential hypertension. Curr Ther Res 34: 1038–1043
Strocchi E, Costa FV, Caldari R, Malini PL, Marata AM, Parini J, Ambrosioni E (1983) Comparison of the antihypertensive activity of cadralazine (ISF 2469) and dihydralazine during chronic treatment. Int J Clin Pharmacol Ther Toxicol 21: 519–523
Scheriff MHR, Howard O, Warren PJ (1978) Effect of atenolol, chlorthalidone and a new combined preparation, Tenoretic, on blood pressure and total body potassium. Acta Ther 4: 51–62
Bateman DN, Dean CR, Ancklow JC, Bulpitt CJ, Dollery CT (1979) Atenolol and chlorthalidone in combination for hypertension. Br J Clin Pharmacol 7: 357–363
Koch-Weser J (1974) Vasodilator drugs in the treatment of hypertension. Arch Intern Med 133: 1017–1027
Editorial (1979) When to use oral vasodilators for hypertension. Drug Ther Bull 17: 57–58
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Catalano, M., Parini, J., Romano, M. et al. Controlled clinical trial of cadralazine as a second-step drug in the treatment of hypertension. Eur J Clin Pharmacol 28, 135–138 (1985). https://doi.org/10.1007/BF00609680
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DOI: https://doi.org/10.1007/BF00609680