Comparison of Propranolol and Hydrochlorothiazide for the Initial Treatment of Hypertension: I. Results of Short-Term Titration with Emphasis on Racial Differences in Response

Propranolol, a beta-adrenergic antagonist (beta-blocker), was developed in the 1960s. By slowing the heart rate and pumping volume, it also lowers blood pressure, and so was used to control hypertension. By the late 1970s a few experts had suggested that propranolol, effective and well-tolerated by many patients, might replace thiazide diuretics as the first step in hypertension treatment. In this article Freis and his colleagues report on a clinical trial that compared the two drugs. They found that they worked equally well in white patients, but that the diuretic hydrochlorothiazide worked better in African-American patients. They recommended that treatment continue to be based on assessment of the individual patient, and that it include a consideration of medication costs; propranolol could cost more than 20 times as much for equivalent doses as hydrochlorothiazide.

NOTE: This was the best scan that could be obtained (photocopy is of poor quality).