Enalapril with Hydrochlorothiazide Provides Effective BP Control In patients with moderate essential hypertension

A randomised study was conducted to investigate the antihypertensive efficacy of enalapril, hydrochlorothiazide alone and in combination. After a 4-week single-blind run-in, 37 patients (supine diastolic SP 100-120mm Hg) or both (n = 6), for 4 weeks in a double-blind fashion. Unless SP was controlled (diastolic < 90mm Hg) the dose of each drug was doubled or combination therapy administered for the next 4 weeks of treatment. Patients then continued with their optimum dosage schedule or were changed to combination therapy, if required, for the final 32 weeks of the trial.

After 4 weeks' therapy, BP was controlled (a reduction of ~ 10mm Hg in supine diastolic SP to < 90mm Hg) in 1/14 evaluable enalapril recipients, 2/13 hydrochlorothiazide recipients and 4/5 combination therapy recipients. All but 1 patient received combination therapy for the second 4 week period of the trial, during which 22/27 patients achieved normal SP. For the final phase of the trial, all patients received combination therapy and 22/24 patients had normalisation of their SP. A number of adverse events were reported, but none were severe enough to require termination of therapy and in most cases they resolved spontaneously or with a decrease in dosage.

Patients with moderate essesntial hypertension on a regular diet may require the combination of hydrochlorothiazide and enalapril rather than either drug alone in order to achieve effective control of SP. Frishman WHo Goldberger J, Sherman D. Journal of Clinical Hypertension 3: 520·527, Dec 1987 7034

14 INPHARMA" 25 June 1988 0156-2703/88/0625·0014/ 0$01 .00/ 0 © ADIS Press