Comparison of the effects of cilazapril in an elderly and nonelderly hypertensive general practice population.
The ACE inhibitor cilazapril was studied in mild to moderate hypertensive patients in general practice to evaluate the effect of age on hypotensive response to low (0.5 and 1 mg) doses. Six hundred and seventy-one patients entered a two week single-blind placebo run-in period and 524 patients were eligible to receive active treatment titrated up to a maximum dose of 5 mg. All patients received 0.5 mg of cilazapril once daily for four weeks. The dose was titrated at monthly intervals to 1, 2.5 and 5 mg once daily if DBP remained > 90 mmHg. If DBP < or = 90 mmHg patients remained at their current dose level until the end of the study. Three hundred and twenty-nine patients < 65 years old and 195 patients > or = 65 years old took active treatment. Binary logistic regression detected no statistically significant difference in response between the two groups (P > 0.2) at low doses of cilazapril. Cumulative response rates (DBP < or = 90 mmHg) for all patients were 24.5%, 40.4%, 54.5% and 62.7% for the escalating dose groups. Cumulative augmented response rate (DBP < or = 90 mmHg and/or reduction in DBP of > or = 10 mmHg) at the 5 mg dose level was 76.7% for all patients. Cilazapril was well tolerated with the pattern of adverse events reflecting those currently documented. A higher proportion of patients than expected responded to the low doses of cilazapril. This effect was not age dependent. These doses are lower than the recommended maintenance doses of 2.5-5 mg in the UK data sheet.(ABSTRACT TRUNCATED AT 250 WORDS)
Dollow
S
S
Roche Products, Welwyn Garden City, UK.
Murray
N
N
Little
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D017315:Cilazapril / Q000009:adverse effects / Q000627:therapeutic use*; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
D017315:Cilazapril