Mild to moderate hypertension usually responds to a β-blocker or a thiazide diuretic. In many patients a combination of the two produces a greater fall in blood pressure than either drug alone, and is often effective in patients who fail to respond to a single drug.1 The combination also has other advantages. β-Blockers prevent the increase in plasma renin activity which sometimes reduces the hypotensive response to a diuretic.2 3 β-Blockers at least acutely cause a small rise in plasma potassium which may tend to counteract the mild hypokalaemia produced by thiazides.4 5 If fluid retention is caused by the β-blocker,6 the diuretic can reverse it.
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