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[Comparison of the efficacy of enalapril + hydrochlorothiazide and captopril + hydrochlorothiazide combinations in mild-to-moderate arterial hypertension by ambulatory measurement of blood pressure]

Author(s): Mayaudon H, Chanudet X, Janin G, Madonna O

Affiliation(s): Service d'Endocrinologie, Hopital Begin, Saint-Mande.

Publication date & source: 1995-05, Ann Cardiol Angeiol (Paris)., 44(5):235-41.

Publication type: Clinical Trial; Multicenter Study; Randomized Controlled Trial

This two-centre trial compared the efficacy of combinations of enalapril + hydrochlorothiazide (E + H) and captopril + hydrochlorothiazide (C + H) on mild-to-moderate hypertension, after a two-week placebo period, in 26 patients with mild-to-moderate HT (DBP between 95 and 114 mmHg) not controlled by previous treatment, randomized under double-blind conditions into two groups for two 4-week crossover treatment periods separated by a 4-week wash-out period. One group received E + H (20 mg/12.5 mg) followed by C + H (50 mg/25 mg) and the other group received C + H (50/25) followed E + H (20/12.5), once a day. The efficacy of the two treatments was evaluated by 24-hour ambulatory blood pressure monitoring (ABPM) at the start of the study and after each treatment period. Plasma renin activity, aldosterone and angiotensin converting enzyme were assayed under the same conditions. Analysis was based on 26 cases, as none of the patients were withdrawn from the trial. No difference was observed between the two groups in terms of the main biometric and laboratory characteristics. Blood pressure evaluated by ABPM and intermittently was not significantly different between the two groups at the time of inclusion in the study. On intermittent Bp determinations, E + H and C + H decreased diastolic and systolic blood pressure, with no significant difference between the two treatments. On ABPM, the two treatments significantly decreased mean systolic, diastolic and mean blood pressure during the diurnal, nocturnal and circadian periods.(ABSTRACT TRUNCATED AT 250 WORDS)

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