Differential antihypertensive effect of acebutolol and hydrochlorothiazide/amiloride hydrochloride combination on elevated exercise blood pressures in hypertensive patients.

The blood presure abilities of the beta receptor antagonist acebutolol and the fixed diuretic combination of hydrochlorothiazide/amiloride hydrochloride to reduce exercise-induced increases in blood presure durng and after standardized ergometric work were compared in a within-patient study of patients with uncomplicated essential hypertension. Both drugs results in a significant (p < 0.01) and almost identical reduction in blood pressure at rest. However, blood pressure during exercise was significantly lower (p < 0.001) with 500 mg of acebutolol than with 50 mg of hydrochlorothiazide and 5 mg of amiloride. This differential effect of the drugs might be of clinical importance because hypertensive patients are particularly endangered by disproportionately high increases in blood pressure during physical activity that is equal to the applied ergometric work loads. From these findings it is concluded that (1) beta-adrenoreceptor blocking agents are the drugs of first choice in the treatment of mild to moderate arterial hypertension, and (2) diuretic drugs potentiate the antihypertensive effect of beta blocking agents.