title: Metabolic effects of the combination of captopril and hydrochlorothiazide in hypertensive subjects.
abstract: The medium-term (16 weeks) effects of the combination of captopril and hydrochlorothiazide (HCTZ) on some metabolic indexes, particularly on plasma lipoproteins, were evaluated in 20 mild to moderate hypertensive outpatients. After a 4-week wash-out period, the subjects were given one tablet of a new commercially available fixed combination once/daily (i.e., captopril 50 mg + HCTZ 25 mg). The dose could be titrated to a maximum of one tablet twice daily according to individual blood pressure responses. Both systolic and diastolic blood pressure significantly decreased at week 4 and showed a further decrease thereafter; the rate of responders (diastolic blood pressure at or below 90 mm Hg at the end of the study) was very high (90%). The only metabolic change was a small though significant increase in HDL cholesterol (P less than .05), almost entirely due to an increase in the denser HDL3 subfraction. The atherogenic fractions, namely total cholesterol, LDL cholesterol, and apoprotein B, showed no significant changes. Plasma triglycerides underwent a transient increase at week 8 (P less than .05) but thereafter fell. Plasma glucose, creatinine, uric acid, and potassium were unchanged. The fixed combination of captopril and HCTZ seems highly effective in lowering blood pressure and seems devoid of untoward metabolic effects. Its overall impact on the coronary risk profile in hypertensive subjects seems therefore to be favorable.
authors.affiliation: Department of Internal Medicine, 1st Medical Clinic, University of Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Perani
authors.forename: A
authors.initials: A
authors.lastname: Martignoni
authors.forename: C
authors.initials: C
authors.lastname: Muggia
authors.forename: T
authors.initials: T
authors.lastname: Ferrari
authors.forename: P
authors.initials: P
authors.lastname: Simonich
authors.forename: R
authors.initials: R
authors.lastname: Pompei
authors.forename: E
authors.initials: E
authors.lastname: Marchesi
authors.forename: G
authors.initials: G
authors.lastname: Finardi
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D002216:Captopril / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D003971:Diastole; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013599:Systole
chemical_list: D008074:Lipoproteins; D006852:Hydrochlorothiazide; D002216:Captopril