Key result
Low-dose captopril (25 mg three times a day) combined with hydrochlorothiazide reduced mean seated diastolic blood pressure to 90 +/- 6 mm Hg compared to 103 +/- 5 mm Hg on placebo.
Why the study?
Does low-dose captopril (alone or combined with hydrochlorothiazide) reduce seated diastolic blood pressure in patients with mild to moderate essential hypertension previously uncontrolled by hydrochlorothiazide?
Does low-dose captopril (alone or combined with hydrochlorothiazide) reduce seated diastolic blood pressure in patients with mild to moderate essential hypertension previously uncontrolled by hydrochlorothiazide?
Low-dose captopril combined with a diuretic effectively reduces diastolic blood pressure in patients with mild to moderate essential hypertension and may be better tolerated than higher doses.
Answers are grounded in this paper and cite their sources.
May support low-dose captopril plus diuretic for mild hypertension; small observational cohort leaves open confirmation in randomized trials.
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.
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Peter H. Vlasses (1982) studied mild to moderate essential hypertension (n=16). Captopril vs. Placebo was evaluated on mean eight-hour seated diastolic blood pressure (SDBP, mm Hg). Low-dose captopril (25 mg three times a day) combined with hydrochlorothiazide reduced mean seated diastolic blood pressure to 90 +/- 6 mm Hg compared to 103 +/- 5 mm Hg on placebo.
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