1 The importance of number of tablets for patient compliance was investigated in 160 patients with mild-moderate essential hypertension treated with a ,8-adrenoceptor blocker and a thiazide diuretic. Mean BP at entry 146 + 16/92 + 8 mm Hg. 2 All patients were given pindolol 10 mg and clopamide 5 mg in one combination tablet or in separate tablets for 4 months respectively. Approximately 90% of the patients took > 90% of the prescribed dose throughout the study. 3 Mean BP decreased progressively and heart rate increased slightly. 4 Side effects were more frequently reported during the first month of the study than previously, and 30 patients discontinued the treatment. No differences in this respect were seen between 1 and 2 tablets daily. 5 Approximately 75% of the patients preferred 1 tablet daily, but combining two drugs in one tablet had no effect upon compliance.

ABSTRACT. The prevalence of secondary and curable hypertension was studied retrospectively in 1000 patients. The concept of “secondary hypertension” was used when hypertension was combined with a disease which may have affected the individual's blood pressure. When this definition was applied, 47 of the patients displayed some form of secondary hypertension: stenosis of the renal artery in 10, renoparenchymal disease in 21, hydronephrosis in 3, and endocrine hypertension in 13 (8 of the latter were using oral contraceptives). The blood pressure normalized in 11 and improved in 7 of these patients after operative treatment of the underlying disease or, when appropriate, discontinuance of intake of contraceptive pills. The incidence of secondary hypertension in this and other series is low, and the number of patients with curable hypertension is even lower. In the majority of cases, secondary hypertension can be diagnosed by anamnesis, physical examination and simple tests of blood and urine. If this basic investigation can be extended, the incidence of stenosis of the renal artery should be examined in the first place. Hypertension in young patients and in patients who are difficult to treat often justifies a more extensive investigation.

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Fifty hypertensive patients on β‐blocker therapy with supine blood pressure ≤95 mmHg were included in a parallel group, double‐blind study for 12 weeks to compare blood pressures, metabolic and adverse effects of additional treatment with diuretics. Hydrochlorothiazide (HCT) 25 mg daily was added to one group and furosemide 30 mg daily in a slow‐release preparation, Lasix Retard (LR), to the other. Blood pressure decreased significantly and similarly in both groups from about 155/101 to about 144/95 mmHg (p<0.01). Diastolic blood pressure was lowered to ≤90 mmHg in 29% of the HCT patients and in 59% of the LR patients. Serum potassium decreased significantly from 4.05 mmol/l to 3.62 mmol/l on HCT, while the decrease on LR from 4.13 mmol/l to 4.05 mmol/l was not significant. Serum urate increased significantly, although within the normal range, on HCT. No change in fasting blood glucose or HbA1C was observed in any pup. The patients were asked to report 40 different possible side‐effects on a visual analogue scale at every visit. The side‐effects already observed on β‐blockers did not change consistently on additional therapy with either HCT or LR. Thus, additional treatment with HCT or LR to patients already treated with β‐blockers results in an equal further blood pressure reduction, but in contrast to treatment with HCT, addition of LR does not affect serum potassium concentrations.

Carotid baroreceptor function has been studied in twenty-five patients with essential hypertension and in ten normotensive control subjects of corresponding age. The carotid baroreceptors were stimulated by increasing the transmural pressure over the carotid arteries by the application of negative pressure in a box enclosing the neck. Stimulation elicited significant decreases in intra-arterial blood pressure, heart rate and cardiac index in both hypertensive and normotensive subjects. Both groups also showed a significant decrease in stroke index and a significant increase in total peripheral vascular resistance index. The response to carotid sinus stimulation did not differ significantly between the two groups. In fourteen of the hypertensive subjects, carotid baroreceptor function was studied after 4 months of saluretic therapy, mefruside, and in nine of these patients after additional treatment with a beta-receptor blocking drug, alprenolol, for another 4 months. Both mefruside and alprenolol induced a significant decrease in mean arterial blood pressure but the response to the carotid baroreceptor stimulation was not significantly altered. The findings indicate that the carotid baroreceptor is re-set to the actual blood pressure level, with little or no change in gain in hypertensive subjects both without and during hypotensive therapy.