Addition of acebutolol to diuretics in hypertension

The effect of acebutolol as an antihypertensive beta receptor-blocking drug was evaluated in 15 patients that remained hypertensive while on diuretics. Observations were made in a small randomized double-blind trial in which the drug was compared to placebo and subsequently during a single-blind phase when the drug was given to those who had not responded to placebo. The dose range for acebutolol was 200 to 600 mg twice daily. Pretreatment plasma renin activity (PRA) and the response to intravenous saralasin infusion were assessed as predictors of the antihypertensive effect of acebutolol. None of six patients receiving placebo had a response of goal blood pressure or below; six of nine receiving acebutolol did respond (P < 0.01). Acebutolol treatment induced reduction in diastolic pressure, heart rate, and PRA during the double-blind phase and a sustained therapeutic response over 18 wk in subjects pooled from both phases of the study. There were no significant correlations between pretreatment PRA, In PRA, or the response to saralasin, and the arterial pressure response to acebutolol therapy. Our data indicate that acebutolol is effective in diuretic-resistant hypertensive patients and that indices of the renin-angiotensin system are not predictors of the therapeutic response.