Long-term efficacy of captopril in the treatment of moderate/intensive arterial hypertension resistant to 3 antihypertensive drugs
Oliván, J.; Miranda, M.J.; Chozas, J.; Gras, B.X.; Garrido, M.
Medicina Clinica 85(14): 571-574
1985
ISSN/ISBN: 0025-7753 PMID: 3908849 Document Number: 259474
In a group of 20 patients (14 women) aged 49 .+-. 12 years with moderate to severe arterial hypertension (AH) who were treated with three drugs (propranolol, chlorthalidone, alphamethyl-dopa) and who persisted with diastolic pressure (DP) of 103.8 mmHg, captopril (C) was substituted for the three drugs, either as monotherapy or associated to a diuretic, to assess its long-term efficacy. One week after the institution of C therapy, DP was reduced to 91 .+-. 8.3 mmHg, with a progressive reduction thereafter. After 6 months of C therapy DP was 86.1 .+-. 6.2 mg Hg (p < 0.001). Systolic arterial pressure showed the same type of response: It was 171.8 .+-. 14.2 mmHg during therapy with 3 drugs and 152.9 .+-. 14.1 mmHg after 6 months of C therapy (p < 0.001). Heart rate after starting captopril returned to the values previous to the 3-drug therapy. After 6 months 100% of patients had a DP < 95 mmHg. Only in 30% and 10% of patients a diuretic and a beta blocker had to be respectively associated to C therapy. In the remaining 40% control was achieved with C monotherapy. During therapy rash was observed in 4 instances; the rash disappeared with an antihistaminic drug and/or a reduction in C dose; in no case C had to be interrupted. It is concluded that C, either as monotherapy or associated to a diuretic, is highly effective for the control of moderate to severe arterial hypertension, with highly significant differences with the triple therapy than these patients were receiving. In addition, C has the advantages of needing only 2 doses a day and allowing a reduction in the total number of drugs to be administered.