[Antihypertensive efficacy and tolerability of diltiazem and enalapril, alone or in combination. DESG. Diltiazem Enalapril Study Group].
OBJECTIVE
Since conversion enzyme inhibitors and calcium inhibitors may have synergic actions, we evaluated the antihypertensive effect and tolerance of prolonged-release diltiazem (300 mg/d) and enalapril (20 mg/d).


METHODS
A double blind study included 176 patients with mild to moderate hypertension. Diltiazem was given to 89 (44 males, 45 females, mean age 49.91 +/- 10.50 years, mean resting diastolic arterial pressure 103 +/- 5 mmHg) and 87 (49 males, 38 females, mean age 51.37 +/- 12.13 years, mean resting diastolic arterial pressure 103 +/- 5 mmHg) received enalapril. Single drug therapy was given for 6 weeks and then continued for another 8 weeks in responders. At the end of the first 6-week period non-responders were given a combination regimen (diltiazem 300 mg and enalapril 20 mg).


RESULTS
After 6 weeks of single drug therapy, 48 patients in the diltiazem group (61.5%) and 53 in the enalapril group (65.4%) had normal blood pressures which remained normal at the end of the trial 8 weeks later in 36 (76%) and 42 (82%) respectively. After 8 weeks of combined regimen 15 of the 24 non-responders (68%) to single drug diltiazem therapy had normal blood pressures as did 18 of the 23 non-responders (78%) to enalapril alone. Tolerance evaluated clinically, biologically and electrocardiographically was comparable to reports in the literature.


CONCLUSIONS
Delayed prolonged-release diltiazem 300 mg and enalapril 20 mg thus had equivalent antihypertensive effects and were equally well tolerated. Combination therapy increased effectiveness without inducing any additional side effects.
Zannad
F
F
Hôpital Central, Nancy.
Gosse
P
P
Bernard-Fernier
M F
MF
de La Garoullaye
A
A
D000328:Adult; D003692:Delayed-Action Preparations; D004110:Diltiazem / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004656:Enalapril / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D003692:Delayed-Action Preparations; D004656:Enalapril; D004110:Diltiazem
Efficacité antihypertensive et tolérance du diltiazem et de l'énalapril, en monothérapie et lors de leur association. DESG. Diltiazem Enalapril Study Group.