Quinapril for treatment of hypertension in Turkey: dose titration and diuretic combination treatment strategies.
OBJECTIVE
Recently the PatenT (Prevalence, awareness, treatment and control of hypertension in Turkey) study showed that while the prevalence of hypertension in Turkey is high, effective control of BP is infrequently achieved. This study investigated the efficacy and safety of quinapril (as monotherapy or in combination with hydrochlorothiazide [HCTZ]) for achieving BP control (target <140/90 mm Hg) in Turkish subjects with mild to moderate hypertension.


METHODS
Two-hundred male and female outpatients aged 19-65 years with mild to moderate hypertension (stage I or II, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 7 guidelines) entered this 12-week, open-label study. All subjects received quinapril 20 mg/day for 6 weeks. If BP targets were achieved at week 6, responders were maintained on 20 mg/day; if BP targets were not achieved, non-responders were randomised to quinapril 40 mg/day or quinapril 20 mg/day + HCTZ 12.5 mg/day for the remainder of the study.


RESULTS
After 6 weeks, 63% of subjects achieved BP targets, and 82% of week-6 responders who continued on quinapril 20 mg/day maintained BP targets at week 12. Of the non-responders, 50% and 52% randomised to quinapril 40 mg/day or quinapril 20 mg/day + HCTZ 12.5 mg/day, respectively, went on to achieve BP targets by week 12. Safety was not compromised with increased dosages or use of combination therapy.


CONCLUSIONS
Quinapril was an effective and safe treatment for achieving and maintaining recommended BP targets in this sample population. These findings will provide clinicians in Turkey with valuable data on the use of quinapril for effective control and management of hypertension.
Yener
Gul
G
Ankara Hospital Internal Medicine Department, Ankara, Turkey. gulgursoyyener@yahoo.com
Aran
Sinan
S
Bahceci
Mithat
M
Ozdemir
Kurtulus
K
Gultekin
Fusun
F
Lowe
Wing
W
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects*; D004232:Diuretics / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage* / Q000009:adverse effects; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D000077583:Quinapril; D012720:Severity of Illness Index; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics; D044005:Tetrahydroisoquinolines; D006852:Hydrochlorothiazide; D000077583:Quinapril
J Int Med Res. 1993 Jan-Feb;21(1):15-25
8319817
J Hypertens. 2002 Apr;20(4):771-7
11910315
J Hum Hypertens. 2004 Apr;18(4):273-8
15037877
J Hypertens. 2003 Mar;21(3):455-7
12640230
Clin Drug Investig. 2000;20(2):81-8
23315349
N Engl J Med. 2000 Jan 20;342(3):145-53
10639539
Diabetes Res Clin Pract. 2002 Oct;58(1):19-25
12161053
J Cardiovasc Pharmacol. 1995 Jul;26(1):114-8
7564350
Kardiologiia. 2003;43(6):28-32
12891308
Arch Intern Med. 2001 Mar 26;161(6):880-5
11268233
Int J Obes Relat Metab Disord. 1998 Nov;22(11):1062-70
9822943
Lancet. 2002 Mar 23;359(9311):995-1003
11937178
Int J Clin Pract Suppl. 2004 Dec;(145):50-4
15617460
J Clin Hypertens (Greenwich). 2002 Nov-Dec;4(6):393-404
12461301
Arch Intern Med. 1997 Nov 24;157(21):2413-46
9385294
Am Heart J. 2004 Apr;147(4):662-8
15077082
Clin Ther. 2004;26 Suppl A:A3-11
15291374
Am Fam Physician. 2005 Jun 1;71(11):2089-90
15952435
Hypertension. 2001 Sep;38(3):449-54
11566921
J Hum Hypertens. 1994 Sep;8(9):725-30
7807504
J Hum Hypertens. 2003 Jul;17(7):505-11
12821958
BMJ. 2003 Jun 28;326(7404):1427
12829555
J Clin Hypertens (Greenwich). 2004 Oct;6(10):569-77
15470286
Ann Pharmacother. 2005 Jul-Aug;39(7-8):1198-203
15956238
J Cardiovasc Pharmacol. 1990;15 Suppl 2:S47-55
1691407
J Hum Hypertens. 2005 Feb;19(2):93-102
15457205
Eur Heart J. 1994 Jul;15(7):940-6
7925516
Hypertension. 2001 Jan;37(1):19-27
11208751
Drugs. 2002;62(2):339-85
11817979
Blood Press. 2002;11(1):53-5
11926352
J Hum Hypertens. 1994 Mar;8(3):155-62
8006914
Am J Cardiol. 2001 May 1;87(9):1058-63
11348602
J Hypertens. 2005 Oct;23(10):1817-23
16148604
Am J Cardiol. 1997 Dec 15;80(12):1594-7
9416943
JAMA. 2003 May 21;289(19):2560-72
12748199
Clin Cardiol. 1990 Jun;13(6 Suppl 7):VII19-25
2189617
Eur J Cardiovasc Prev Rehabil. 2005 Jun;12(3):243-9
15942423
Arch Intern Med. 2000 Jun 26;160(12):1842-7
10871979
Am J Cardiol. 2001 Nov 8;88(9A):1L-20L
11694220
J Hypertens. 2003 Nov;21(11):1983-92
14597836