Combined treatment with captopril, hydrochlorothiazide and pravastatin in dyslipidemic hypertensive patients.
OBJECTIVE
Hypertension and hypercholesterolemia frequently coexist, necessitating concurrent treatments for both disorders. The present study aimed at evaluating the efficacy, the safety, and the toleration of captopril, an ACE inhibitor, hydrochlorothiazide, a diuretic, and pravastatin, a HMG-CoA reductase inhibitor co-administered in hypertensive patients in general practice.


METHODS
The patients were followed for 16 weeks and asked to comply with a lipid lowering diet for the whole period. Captopril, 50 mg/once daily, was administered alone for the first 4 weeks. Hydrochlorothiazide, 25 mg/day, was added after 4 weeks if required. Pravastatin treatment (20 mg/day) was started at the 8th week of the study and its dose was doubled 4 weeks later if needed.


METHODS
A total of 603 patients with hypertension (diastolic blood pressure > or = 95 mmHg) and dyslipidemia (total cholesterol > 6.5 mmol/l) were included.


METHODS
The study was performed in general practice by 230 physicians.


METHODS
Determination of blood pressure, circulating levels of total cholesterol, HDL-cholesterol and triglycerides, and blood chemistry for safety monitoring.


RESULTS
At the end of the trial 75.1% of patients had their diastolic blood pressure < or = 90 mmHg and 43.5% a total cholesterol level < 6.5 mmol/l. The overall incidence of adverse events was 21.7%, leading to withdrawal in 10.9% of the total number of patients. The combined treatments had no deleterious effect on safety variables.


CONCLUSIONS
Captopril, hydrochlorothiazide and pravastatin are effective and well tolerated medications to treat dyslipidemic hypertensive patients.
Waeber
B
B
Division d'Hypertension, CHUV, Lausanne, Switzerland.
Greminger
P
P
Riesen
W
W
Darioli
R
R
Simeon-Dubach
D
D
Wunderlin
R
R
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002216:Captopril / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004232:Diuretics; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects / Q000627:therapeutic use; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D006949:Hyperlipidemias / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy*; D006973:Hypertension / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000627:therapeutic use; D011446:Prospective Studies; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
D000806:Angiotensin-Converting Enzyme Inhibitors; D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D004232:Diuretics; D004791:Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D049993:Sodium Chloride Symporter Inhibitors; D006852:Hydrochlorothiazide; D002216:Captopril; D017035:Pravastatin