Controlling hypertension: lisinopril-hydrochlorothiazide vs captopril-hydrochlorothiazide. An Italian multicentre study.
The efficacy and tolerability of a combination of lisinopril 20 mg and hydrochlorothiazide 12.5 mg once daily (L/HCTZ) was compared with a combination of captopril 50 mg and hydrochlorothiazide 25 mg once daily (C/HCTZ) in a multicentre, open, randomized, parallel-group study involving mild to moderate hypertensive patients. A total of 87 patients were randomized to lisinopril and 87 to captopril. Six weeks of treatment with lisinopril or captopril lowered supine BP by 13.3/8.8 mm Hg and 8.7/6.5 mm Hg, respectively. After 4 weeks of combination treatment, BP 24 hours post dose fell to 144.0 +/- 1.3/88.1 +/- 0.7 mm Hg in the L/HCTZ group vs 146.8 +/- 1.3/90.3 +/- 0.7 mm Hg in the C/HCTZ group (P less than 0.05 DBP; differences in SBP were not significant, ns). The proportion of patients normalized (DBP less than or equal to 90 mm Hg) was 79.5% vs 72% for L/HCTZ and C/HCTZ, respectively (ns). A total of 93.6% of patients on L/HCTZ achieved a fall in DBP of greater than or equal to 10 mm Hg, compared with 86.7% of patients on C/HCTZ (ns). One patient on lisinopril withdrew because of coughing. No statistically significant differences were observed between L/HCTZ and C/HCTZ with regard to adverse events. In conclusion, L/HCTZ was as well tolerated as C/HCTZ, but produced a greater fall in DBP.
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Istituto di Patologia Medica, Universita degli Studi, Ancona, Italy.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D002216:Captopril / Q000008:administration & dosage* / Q000009:adverse effects; D004338:Drug Combinations; D004656:Enalapril / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage* / Q000009:adverse effects; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007558:Italy; D017706:Lisinopril; D008297:Male; D008875:Middle Aged
D000806:Angiotensin-Converting Enzyme Inhibitors; D004338:Drug Combinations; D006852:Hydrochlorothiazide; D004656:Enalapril; D002216:Captopril; D017706:Lisinopril