Combination of a thiazide, a vasodilator and reserpine compared with methyldopa
plus hydrochlorothiazide in the treatment of hypertension in Zimbabwe.
Author(s): Stein CM, Neill P, Mwaluko GM, Kusema T.
Affiliation(s): Department of Clinical Pharmacology, University of Zimbabwe, Harare.
Publication date & source: 1990, S Afr Med J. , 77(5):243-5
Brinerdin (Sandoz), a combination of a diuretic (clopamide 5 mg), a vasodilator
(dihydro-ergocristine 0.5 mg) and reserpine (0.1 mg) (CDR) was compared with
methyldopa (MD) plus hydrochlorothiazide (HCT) for antihypertensive effect,
adverse reactions, compliance and patient preference in an open cross-over trial.
Eighteen patients completed both arms of the trial and 5 patients who completed
the CDR arm were withdrawn while on the MD arm because of adverse effects in 4
and poor control in 1. On HCT 50 mg daily the mean baseline systolic blood
pressure was 163.9 +/- 16.3 mmHg and the diastolic blood pressure was 105.9 +/-
6.7 mmHg. On CDR these were reduced to systolic blood pressure 140.3 +/- 15.1
mmHg and diastolic blood pressure 87.8 +/- 9.3 mmHg. On MD + HCT the systolic
blood pressure was reduced to 138.5 +/- 16.9 mmHg and the diastolic blood
pressure to 88.9 +/- 10.3 mmHg. The differences between the two treatment periods
in systolic blood pressure (1.8 mmHg; 95% confidence interval (CI) - 4.1 + 7.7
mmHg) and diastolic blood pressure (1.1 mmHg; 95% CI - 4.6 + 2.4 mmHg) were not
significant with P values of 0.6 and 0.7 respectively. Compliance was 98.2% for
CDR and 94.7% for MD + HCT (P = 0.02). Unusual sleepiness occurred more
frequently in the MD arm (P less than 0.01). Thirteen patients chose to continue
on CDR, 2 on MD + HCT and 3 had no preference (P = 0.005). CDR is similar in
antihypertensive effect to MD + HCT but is better tolerated with fewer
withdrawals, fewer adverse effects, better compliance and has more patients
electing to continue taking it.
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