What question did this study set out to answer?

This research aims to evaluate the effectiveness and tolerability of enalapril combined with low doses of hydrochlorothiazide in patients whose hypertension does not respond to enalapril alone.

July 1, 1995American Journal of Hypertension

The efficacy and tolerability of enalapril in a formulation with a very low dose of hydrochlorothiazide in hypertensive patients resistent to enalapril monotherapy

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Why the study?

Does the addition of very low (6 mg) or low (12.5 mg) dose hydrochlorothiazide to enalapril improve blood pressure reduction in patients with essential hypertension resistant to enalapril monotherapy?

Population

296 patients with mild to moderate essential hypertension and persistent supine diastolic blood pressure >…

Comparison

Enalapril combined with very low dose or low… vs Enalapril plus placebo for 8 weeks

Design

RCT, randomized, double-blind

Follow-up

8 weeks

Authors

GJGuul Sven JørnVejle Sygehus OIO.S. IngridOslo University Hospital AJAntti J. JounelaVejle Sygehus

Discussion

Member takes

Implication

Supports adding low-dose HCTZ to enalapril for resistant hypertension; extends evidence for synergistic BP reduction at doses avoiding metabolic effects.

Key Points

This research aims to evaluate the effectiveness and tolerability of enalapril combined with low doses of hydrochlorothiazide in patients whose hypertension does not respond to enalapril alone.
Randomized trial involving 402 patients with hypertension, initially treated with enalapril.
Eligible patients (n = 296) received either enalapril/placebo, 6 mg enalapril/HCTZ, or 12.5 mg enalapril/HCTZ for 8 weeks.
Conducted in a double-blind design measuring blood pressure changes after treatment.
Group II (6 mg HCTZ) showed a mean blood pressure reduction of 7.3 mm Hg (95% CI, -9.0; -6.2), P < 0.01.
Group III (12.5 mg HCTZ) showed a mean reduction of 7.7 mm Hg (95% CI, -9.2; -6.3), P < 0.01.
No significant difference in side effects across the treatment groups.

Structured PICO

Population

296 patients with mild to moderate essential hypertension and persistent supine diastolic blood pressure > 95 mm Hg after 8 weeks of enalapril 20 mg monotherapy

Intervention

Enalapril combined with very low dose (6 mg) or low dose (12.5 mg) hydrochlorothiazide (HCTZ) for 8 weeks

Comparator

Enalapril plus placebo for 8 weeks

Outcome

Mean reduction in blood pressure at 8 weekssurrogate

Adding a very low dose (6 mg) of hydrochlorothiazide to enalapril provides synergistic blood pressure reduction without adverse metabolic effects in patients resistant to enalapril monotherapy.

Cite This Study

Jørn et al. (1995) studied this question.

synapsesocial.com/papers/6a20f55834bef10fdaeb2d51 https://doi.org/10.1016/0895-7061(95)00106-y

Topics

Hypertension management

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Implication

Supports adding low-dose HCTZ to enalapril for resistant hypertension; extends evidence for synergistic BP reduction at doses avoiding metabolic effects.

The efficacy and tolerability of enalapril in a formulation with a very low dose of hydrochlorothiazide in hypertensive patients resistent to enalapril monotherapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

The efficacy and tolerability of enalapril in a formulation with a very low dose of hydrochlorothiazide in hypertensive patients resistent to enalapril monotherapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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