Comparative effects of zofenopril and hydrochlorothiazide on office and ambulatory blood pressures in mild to moderate essential hypertension.

Thirty-eight patients with mild to moderate essential hypertension (seated diastolic 95-110 mm Hg) were randomized double-blind to treatment with either zofenopril (n = 19) or hydrochlorothiazide (n = 19) over a period of 12 weeks. 2. Office blood pressure, heart rate, side effects and metabolic changes were assessed at the end of the run-in period on placebo and after 4, 8, 12 weeks treatment at the same time, 22-24 h after the last dosing. Ambulatory recordings over 14 h (8 h to 22 h) were performed at the end of placebo period and after active treatment for 12 weeks. 3. The two regimes reduced office blood pressures equally with minimal additional effect seen on increasing the dose. Both zofenopril and hydrochlorothiazide lowered average baseline ambulatory blood pressure, but zofenopril had greater efficacy in reducing BP during some working hours. 4. Adverse reactions were mild and transient with both drugs. There were no significant changes in laboratory values. 5. Thus hydrochlorothiazide and zofenopril given once daily at low dosage both reduce office and ambulatory blood pressures and are well tolerated.