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Its Use in Mild to Moderate Hypertension Unresponsive to Diuretic Treatment

Peter H. Vlasses, PharmD; Heschi H. Rotmensch, MD; Brian N. Swanson, PhD; Parviz Mojaverian, PhD; Roger K. Ferguson, MD

Arch Intern Med. 1982;142(6):1098-1101.

Abstract
• The effect of low doses (25 mg three times a day) of captopril was evaluated in 16 patients with mild to moderate essential hypertension, previously uncontrolled by hydrochlorothiazide. After a no-treatment period, mean eight-hour seated diastolic blood pressure (SDBP, mm Hg) was 103 ± 5 on placebo, 95 ± 8 after a single dose of captopril, 96 ± 4 after two weeks of captopril alone, and 90 ± 6 after its combination with hydrochlorothiazide. Though nine patients had at least a 10% fall in SDBP after the initial dose of captopril, only three had a comparable fall after two weeks; after captopril and hydrochlorothiazide, however, 12 patients had such a response. Captopril decreased mean angiotensin-converting enzyme activity and plasma aldosterone, though to a lesser extent with continued therapy. Because its side effects appear dose related, low doses of captopril combined with a diuretic are effective and may be better tolerated.

(Arch Intern Med 1982;142:1098-1101)

Author Affiliations
From the Division of Clinical Pharmacology, Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia.

Footnotes
Accepted for publication Nov 20, 1981.

Reprint requests to Division of Clinical Pharmacology (M-504), Thomas Jefferson University Hospital, 11th and Walnut streets, Philadelphia, PA 19107 (Dr Vlasses).

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