The Antihypertensive and Metabolic Effects of Low and Conventional Dose Cyclopenthiazide in Type II Diabetics with Hypertension

The antihypertensive efficacy and metabolic effects of cyclopenthiazide125 µg were compared with cyclopenthiazide 500 µgin patients with non-insulin dependent diabetes and hypertensionin a double blind, randomized crossover study. After a 6-weekplacebo period 24 patients with non-insulin dependent diabetesmellitus, stabilized on diet or oral hypoglycaemic agents, whohad a mean diastolic blood pressure between 90 and 120 mmHgafter receiving placebo for 6 weeks were given 125 µgor 500 µg cyclopenthiazide for 12 weeks. Patients thenreceived placebo for a further 6-week period, following whichthey received the alternate treatment dosage for 12 weeks. Therewere no differences between doses in their antihypertensiveeffects. While 500 µg significantly reduced systolic anddiastolic blood pressures, only diastolic pressure was significantlyreduced by 125 µg from pre-treatment values. The higherdose of cyclopenthiazide had greater effects on measures ofdiabetic control than did the 125 µg dose and the risein blood glucose after 12 weeks' treatment with 500 µgwas significantly different from pre-treatment values. Cyclopenthiazide125 µg had significantly less effect on triglycerides,potassium and urate, than did 500 µg. Cyclopenthiazide500 µg resulted in a significant fall in serum potassiumfrom pre-treatment values. There were no intertreatment differencesin the other variables measured. Cyclopenthiazide 125 µgis as effective as 500 µg in reducing diastolic bloodpressure in mildly hypertensive non-insulin dependent diabeticpatients. The higher dose had more pronounced adverse effectson glucose control and serum concentrations of triglycerides,potassium and urate.