A comparison between spironolactone and hydrochlorothiazide with and without alpha-methyldopa in the treatment of hypertension.

In a single blind crossover trial, spironolactone (50 mg twice a day), and hydrochlorothiazide (50 mg twice a day) were equally effective hypotensive agents in 16 patients with untreated essential hypertension. The addition of alpha-methyldopa (250 mg three times a day) to each agent produced a further significant and equal fall in blood pressure. Spironolactone therapy was assoicated with fewer clinical and biochemical side effects. The hypotensive effect of the diuretics was independent of the renin status of the patients.