Single administration of captopril and combined use with beta-blocker and/or thiazide diuretic in the treatment of essential hypertension.
Thirty-four patients with essential hypertension at WHO stage I or II were divided into three groups. Group I consisted of 22 cases who displayed normal renin activity (NR) or low renin activity (LR) and who received a single administration of captopril. Group II consisted of 6 cases given beta-blockers after administration of captopril. Group III consisted of 6 cases in whom beta-blocker was replaced with thiazide diuretics after administration of captopril alone. Blood pressure decreased significantly by captopril treatment alone in group I of the NR and LR subgroups (except for the diastolic blood pressure [DBP] of the NR subgroup) and fell below the target blood pressure (SBP of 165 mmHg and DBP of 95 mmHg) in 86% of the NR subgroup and 73% of the LR subgroup. Combined treatment with captopril and beta-blocker in Group II did not decrease blood pressure any lower than with captopril alone treatment and achieved the target blood pressure in only 50% of the patients. In group III, combined treatment with captopril and thiazide achieved the target blood pressure in 100% of the patients. Plasma renin activity (PRA) was increased by captopril but reduced by captopril in combination with beta-blocker. However, when beta-blocker was replaced with thiazide, PRA increased. The serum sodium concentration was significantly reduced in the LR subgroup after a single administration of captopril, but there was no other variation.
Third Department of Internal Medicine, Nagoya City University Medical School, Japan.
S
S
Yoneda
T
T
Kako
M
M
Koketsu
J
J
Hayano
T
T
Asakawa
T
T
Fujinami
T
T
Kato
D000070:Acebutolol / Q000008:administration & dosage; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000450:Aldosterone / Q000097:blood; D001581:Benzothiadiazines; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000008:administration & dosage*; D004232:Diuretics; D004359:Drug Therapy, Combination; D005665:Furosemide / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood; D012964:Sodium / Q000097:blood; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D001581:Benzothiadiazines; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D000450:Aldosterone; D000070:Acebutolol; D005665:Furosemide; D002216:Captopril; D012964:Sodium; D012083:Renin; D011188:Potassium