title: [Do clinical parameters exist that permit predicting the need to combine a diuretic with captopril in the initial treatment of essential arterial hypertension?].
abstract: In the present work the clinical, biological, radiological, electrocardiographic and hormonal characteristics are analyzed in 51 patients suffering mild essential hypertension, in whom treatment with captopril in monotherapy or associated to chlortalidone managed to normalize arterial pressure and maintained the pressure control during a period of one year. Captopril in monotherapy at a dose of 50 to 150 mg/day normalized blood pressure in 34 patients (66.7%) while in the remaining 17 patients (33.3%) the association of 25 mg of Chlortalidone was required. When comparing the subgroup of patients whose blood pressure levels were controlled with captopril as the only used drug (Group A) against those who required the association with diuretics (Group B), we could only observe significant differences regarding the blood pressure level and cardiothoracic index, being these higher in the group of patients who required pharmacologic association. We conclude that only the severity of hypertension allows to predict the necessity of associating a diuretic to captopril in order to obtain the control of blood pressure levels.
authors.affiliation: Servicio de Medicina Interna General, Facultad de Medicina, Universidad de Barcelona.
authors.forename: A
authors.initials: A
authors.lastname: Coca
authors.forename: A
authors.initials: A
authors.lastname: de la Sierra
authors.forename: J
authors.initials: J
authors.lastname: Sobrino
authors.forename: M T
authors.initials: MT
authors.lastname: Aguilera
authors.forename: J
authors.initials: J
authors.lastname: Closas
authors.forename: M
authors.initials: M
authors.lastname: Sánchez
authors.forename: A
authors.initials: A
authors.lastname: Urbano-Márquez
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000008:administration & dosage / Q000627:therapeutic use*; D002752:Chlorthalidone / Q000008:administration & dosage; D004039:Diet, Sodium-Restricted; D004232:Diuretics / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D004232:Diuretics; D002216:Captopril; D002752:Chlorthalidone
vernacular_title: Existen parámetros clínicos que permitan predecir la necesidad de asociar un diurético al captopril en el tratamiento inicial de la hipertensión arterial esencial?