Third-line therapy. A cautionary note.

Abstract

Ten patients who failed to achieve a satisfactory blood pressure level with dual therapy of a diuretic and a beta-blocker were allocated to captopril, nifedipine and methyldopa in random order as third-line therapy. Four patients failed to respond to any third-line agent; one patient responded to all three agents, two to nifedipine and captopril and one only to captopril. Third-line therapy is frequently ineffective and several agents may have to be tried to achieve an adequate response.