Comparison of a fixed ratio combination of hydrochlorothiazide, amiloride and timolol ('Moducren') given once versus twice daily in mild to moderate hypertension.

An open, multi-centre study was carried out in general practice to compare the efficacy and tolerance of antihypertensive therapy with once-daily and twice-daily dosage of a fixed ratio combination of hydrochlorothiazide (25 mg), amiloride (2.5 mg) and timolol (10 mg). A total of 604 patients with mild to moderate hypertension were treated over a period of 12 weeks with either 1 to 2 tablets once-daily (294 patients) or 1/2 to 1 tablet twice-daily (310 patients). The results showed that there was a significant reduction in systolic and diastolic blood pressures in both groups after only 2-weeks' therapy and the overall reduction after 12 weeks was 31/19 mmHg, with 57% of patients being adequately controlled on the equivalent of 1 tablet per day, whether taken once daily or in divided doses. Forty-six (8%) patients withdrew from the study because of drug-related symptoms, mainly central nervous system in origin. Overall, treatment with either regimen was considered suitable and acceptable by over 80% of patients and doctors.