title: Usefulness of piretanide plus ramipril for systemic hypertension: a multicenter trial.
abstract: To test the dose responses of piretanide, ramipril, and their combination in patients with essential hypertension, a prospective, randomized, double-blind, placebo-controlled trial was conducted in 480 patients. Twelve separate groups were studied: placebo, piretanide 3 mg, piretanide 6 mg, ramipril 2.5 mg, ramipril 5 mg, ramipril 10 mg, and their combinations, as single daily morning doses. Patients were randomized after a 2-week run-in period without drugs; treatment was given for 6 weeks. A dose response compared with placebo was found for both drugs; the combination was more effective than either drug alone. Piretanide 6 mg, combined with ramipril 5 mg, provided optimal blood pressure reduction. Self-reported adverse effects of both drugs and their combinations did not exceed those reported for placebo. A surface analysis suggested that piretanide primarily reduced systolic blood pressure, whereas ramipril was more effective in reducing diastolic blood pressure. The data attest to a combined efficacy of piretanide and ramipril in decreasing arterial blood pressure.
authors.affiliation: Nephrology and Hypertension Section, Franz-Volhard-Klinik, Berlin, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Homuth
authors.forename: H D
authors.initials: HD
authors.lastname: Faulhaber
authors.forename: U
authors.initials: U
authors.lastname: Loose
authors.forename: K
authors.initials: K
authors.lastname: Löffler
authors.forename: F C
authors.initials: FC
authors.lastname: Luft
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D004232:Diuretics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011187:Posture; D011446:Prospective Studies; D017257:Ramipril / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016683:Supine Position
chemical_list: D004232:Diuretics; D004338:Drug Combinations; D010919:Placebos; D013449:Sulfonamides; C015451:piretanide; D017257:Ramipril