A review of the benzothiadiazine derivatives in relation to cardiovascular disease

Treatment of Edematous States and Hypertension With Bendroflumethiazide (Naturetin)

“…Although the attempt to reduce blood pressure in patients with uncomplicated hypertension and hypertensive cardiovascular disease met with less outstanding success, the favorable results unquestionably overbalanced the poor ones. The consensus of other investigators is that not only are thiazide derivatives effective agents in the treatment of hypertension, but that the best results are obtained with bendroflumethiazide (6). Some clinicians have used dosages as high as 30 or 40 mg. a day with good effect, and with little or no evidence of toxicity (7, 8).…”

Combined Rauwolfia‐diuretic Therapy in Hypertension

“…Like chlorothiazide, both possess potent diuretic properties similar to those of the mercurial diuretics, in that they produce a marked increase in the urinary output of sodium and chloride and a lesser effect on potassium and bicarbonate excretion (11–12). Bendroflumethiazide, however, is the more potent; indeed, it is the most potent member of the benzothiadiazine group of diuretic compounds (8, 11), being approximately 100 times as active as chlorothiazide (12–14) or flumethiazide (12). Thus, 4 mg. of bendroflumethiazide would be expected to be approximately equal to 400 mg. of flumethiazide in diuretic effect.…”

“…Although the results have varied (4), it has been established that drastic restriction of dietary sodium will lower the blood pressure of hypertensive patients (5–6), and that low‐sodium diets will increase their responsiveness to antihypertensive drugs and other therapeutic procedures (7). Some authorities attribute the antihypertensive effects of chlorothiazide and other diuretic drugs primarily to their sodium‐depleting action since the results are similar to those obtained by drastic sodium restriction; both forms of treatment reduce the extracellular fluid and plasma volumes, decrease the total amount of exchangeable body sodium and cardiac output, and enhance the effect of antihypertensive drugs (5, 7, 8). Other authorities acknowledge that natriuresis is an important factor, especially in the initial antihypertensive effects of these agents, but that their late effects may be due to interference with some arterial pressor mechanism (9).…”

“…Other authorities acknowledge that natriuresis is an important factor, especially in the initial antihypertensive effects of these agents, but that their late effects may be due to interference with some arterial pressor mechanism (9). Whether or not further study will establish that the benzothiadiazine diuretic drugs possess a specific antihypertensive action apart from their natriuretic effect, their value in the treatment of hypertension, when administered alone (5, 7, 10) and especially when combined with established antihypertensive drugs (5, 8, 10), has been clearly demonstrated.…”

Rauwolfia‐bendroflumethiazide in the Treatment of Hypertension

“…Whatever the mechanism of action may be, the natruretic agents have become the most widely used of the antihypertensive drugs because they are easy to administer and relatively free from disagreeable side effects besides being effective in reducing the blood pressure of many hypertensive patients (5). The usefulness of the benzothiadiazine diuretic agents has been repeatedly demonstrated, not only when they are administered as the basic antihypertensive medication, but also and especially when they are administered concomitantly with established antihypertensive drugs (10).…”