Treating mild-to-moderate hypertension: a comparison of lisinopril-hydrochlorothiazide fixed combination with captopril and hydrochlorothiazide free combination.
The fixed combination comprising lisinopril 10 mg and hydrochlorothiazide 12.5 mg once daily (L/HCTZ) was compared with captopril 25 mg and hydrochlorothiazide 25 mg once daily (C/HCTZ) in a randomized, double-blind, parallel-group study. After a 2-4 week placebo run-in period patients were randomized to L/HCTZ (n = 82) or C/HCTZ (n = 83) for 8 weeks. After 8 weeks, peak blood levels of both treatments showed lowered sitting BPs (-22.8/-14.3 mm Hg for L/HCTZ vs -22.8/-14.0 mm Hg for C/HCTZ), and standing BPs (-22.6/-13.1 mm Hg vs -21.6/-12.8 mm Hg, respectively). Between-drug differences were not significant (ns). At trough blood levels L/HCTZ lowered sitting BPs more than C/HCTZ, -23.6/-14.9 mm Hg vs -16.0/-11.3 mm Hg (P less than 0.02/less than 0.03), respectively. The effect on standing BP was similar, -22.0/-13.8 mm Hg vs -15.1/-10.3 mm Hg (P less than 0.03/less than 0.05) for L/HCTZ and C/HCTZ, respectively. Both treatments slightly increased heart rate (ns). Serum potassium fell more with C/HCTZ than with L/HCTZ (P less than 0.005). The fasting glucose level rose with L/HCTZ and fell with C/HCTZ. Uric acid, triglycerides and fasting cholesterol levels rose in both groups (ns). There were no differences between treatments with respect to adverse events. L/HCTZ appears to be a well-tolerated combination with efficacy on once-daily dosing superior to that of C/HCTZ.
Graham
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D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002216:Captopril / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004338:Drug Combinations; D004359:Drug Therapy, Combination; 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 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D017706:Lisinopril; D008297:Male; D008875:Middle Aged
D000806:Angiotensin-Converting Enzyme Inhibitors; D004338:Drug Combinations; D006852:Hydrochlorothiazide; D004656:Enalapril; D002216:Captopril; D017706:Lisinopril