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Enalapril, hydrochlorothiazide, and combination therapy in patients with moderate hypertension.
J Clin Hypertens. 1987 Dec; 3(4):520-7.JC

Abstract

Using a placebo baseline, positive controlled, double-blind, randomized titration to effect our study protocol, we assessed the antihypertensive actions of enalapril, hydrochlorothiazide, and their combination in 37 patients with moderate essential hypertension. Patients were maintained on their regular diets and received a placebo for 4 weeks. Patients with moderate systemic hypertension were randomized to receive enalapril monotherapy at a dose of 10 mg twice daily (n = 16), hydrochlorothiazide monotherapy at a dose of 25 mg twice daily (n = 15), or combination therapy consisting of 10 mg enalapril and 25 mg hydrochlorothiazide twice daily (n = 6). Therapy could be titrated to twice the starting dose. All treatment regimens reduced blood pressure, but only one patient had blood pressure normalized (diastolic blood pressure less than or equal to 90 mmHg) with enalapril (7%), two patients with hydrochlorothiazide (15%), and 80% of patients with combination therapy. The patients who had not achieved normal blood pressure received combination treatment, and after 8 additional weeks, more than 70% showed normal blood pressure. After one year of combination therapy, 92% of the patients continue to have normal blood pressure. Both the monotherapy and combination regimens were very well tolerated in this study. In conclusion, enalapril, hydrochlorothiazide, and their combination are effective in reducing blood pressure in patients with moderate hypertension. However, monotherapy is successful in normalizing blood pressure only in a small percentage of patients. Combination therapy achieved normalization of blood pressure in almost all patients, suggesting that most patients on regular diets with moderate hypertension may require a diuretic-ACE inhibitor combination rather than monotherapy to achieve effective blood pressure control.

Authors+Show Affiliations

Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

2839628

Citation

Frishman, W H., et al. "Enalapril, Hydrochlorothiazide, and Combination Therapy in Patients With Moderate Hypertension." Journal of Clinical Hypertension, vol. 3, no. 4, 1987, pp. 520-7.
Frishman WH, Goldberger J, Sherman D. Enalapril, hydrochlorothiazide, and combination therapy in patients with moderate hypertension. J Clin Hypertens. 1987;3(4):520-7.
Frishman, W. H., Goldberger, J., & Sherman, D. (1987). Enalapril, hydrochlorothiazide, and combination therapy in patients with moderate hypertension. Journal of Clinical Hypertension, 3(4), 520-7.
Frishman WH, Goldberger J, Sherman D. Enalapril, Hydrochlorothiazide, and Combination Therapy in Patients With Moderate Hypertension. J Clin Hypertens. 1987;3(4):520-7. PubMed PMID: 2839628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enalapril, hydrochlorothiazide, and combination therapy in patients with moderate hypertension. AU - Frishman,W H, AU - Goldberger,J, AU - Sherman,D, PY - 1987/12/1/pubmed PY - 1987/12/1/medline PY - 1987/12/1/entrez SP - 520 EP - 7 JF - Journal of clinical hypertension JO - J Clin Hypertens VL - 3 IS - 4 N2 - Using a placebo baseline, positive controlled, double-blind, randomized titration to effect our study protocol, we assessed the antihypertensive actions of enalapril, hydrochlorothiazide, and their combination in 37 patients with moderate essential hypertension. Patients were maintained on their regular diets and received a placebo for 4 weeks. Patients with moderate systemic hypertension were randomized to receive enalapril monotherapy at a dose of 10 mg twice daily (n = 16), hydrochlorothiazide monotherapy at a dose of 25 mg twice daily (n = 15), or combination therapy consisting of 10 mg enalapril and 25 mg hydrochlorothiazide twice daily (n = 6). Therapy could be titrated to twice the starting dose. All treatment regimens reduced blood pressure, but only one patient had blood pressure normalized (diastolic blood pressure less than or equal to 90 mmHg) with enalapril (7%), two patients with hydrochlorothiazide (15%), and 80% of patients with combination therapy. The patients who had not achieved normal blood pressure received combination treatment, and after 8 additional weeks, more than 70% showed normal blood pressure. After one year of combination therapy, 92% of the patients continue to have normal blood pressure. Both the monotherapy and combination regimens were very well tolerated in this study. In conclusion, enalapril, hydrochlorothiazide, and their combination are effective in reducing blood pressure in patients with moderate hypertension. However, monotherapy is successful in normalizing blood pressure only in a small percentage of patients. Combination therapy achieved normalization of blood pressure in almost all patients, suggesting that most patients on regular diets with moderate hypertension may require a diuretic-ACE inhibitor combination rather than monotherapy to achieve effective blood pressure control. SN - 0748-450X UR - https://www.unboundmedicine.com/medline/citation/2839628/Enalapril_hydrochlorothiazide_and_combination_therapy_in_patients_with_moderate_hypertension_ L2 - https://medlineplus.gov/highbloodpressure.html DB - PRIME DP - Unbound Medicine ER -