Detection and follow-up of moderate and severe hypertensive subjects in the Australia community

Controlled comparison of the effects of furosemide and hydrochlorothiazide added to propranolol in the treatment of hypertension

Forty patients completed a double-blind parallel group study comparing furosemide (FUR) and hydrochlorothiazide (HCT) when added to a stable dose of beta blocker in the treatment of mild to moderate hypertension. Both diuretics caused a significant additional fall in blood pressure (BP) when added to propranolol, and there were no differences in the mean BP achieved. However, a higher proportion of patients achieved satisfactory control (BP less than 160/95 mm Hg) on FUR than on HCT and, in addition, there was a more marked dose-response effect with FUR. This study showed that FUR is at least as effective as HCT in the treatment of hypertension when added to propranolol, and appears to possess certain advantages in comparison to the thiazide.

Biochemical and haematological changes induced by tienilic acid combined with propranolol in essential hypertension

Sixteen patients with moderate essential hypertension completed a double-blind crossover trial with four treatment periods each of 6 weeks. They received in random order: placebo; tienilic acid 250 mg/day; propranolol 80 mg twice daily; and tienilic acid 250 mg/day combined with propranolol 80 mg twice daily. Average blood-pressure in the lying position was 22.6/13.1 kPa (169/98 mm Hg) on placebo; 21.0/12.5 (157/94) on tienilic aicd; 21.2/12.0 (159/90) on propranolol, and 18.9/11.5 (142/86) on tienilic acid combined with propranolol. The effects of tienilic acid and propranolol on blood-pressure were additive and there were no statistically significant interactions. Tienilic acid significantly reduced serum-urate from 0.33 to 0.18 mmol/l and induced hypokalaemia which was corrected by propranolol. Basophil count and haemoglobin were lower after tienilic acid treatment than they had been at the start of the study.

Coronary risk factor screening and long-term follow up: year 1 of the Sydney Coronary Heart Disease Prevention Programme

Ten thousand self-referred Sydney inhabitants were screened for major coronary risk factors over one year. Individual "problems" were referred to general practitioners for further assessment and treatment. Seventy-four per cent of subjects have attended a general practitioner where relevant. For subjects under 65 years, 29% had unsuspected hyperlipidaemia, 11% had unsuspected hypertension, and 0.6% had unsuspected diabetes. Nineteen per cent of subjects reported a past history of hypertension, of whom 46% appeared to be well-controlled (diastolic blood pressure less than 95 mmHg). The numbers of cigarette smokers fell with increasing age. Considering hyperlipidaemia, hypertension and cigarette smoking in subjects under 40 years of age, 10.4% of males and 4.9% of females had two or more coronary risk factors. Three hundred and fifty-four subjects selected at random, who claimed to be receiving treatment as a result of initial screening were invited for retesting eight and 15 months later. Significant falls were noted in body weight, blood pressure, and plasma cholesterol readings.