Key result
Captopril normalized blood pressure in 75% of elderly patients (lowering mean BP to 161/78 mm Hg), producing similar reductions to triamterene/hydrochlorothiazide but without biochemical changes.
Why the study?
Does captopril improve blood pressure and tolerability compared to triamterene and hydrochlorothiazide in elderly patients with mild to moderate hypertension?
RCT (n=40)
Single-blind
Cross-over
Does captopril improve blood pressure and tolerability compared to triamterene and hydrochlorothiazide in elderly patients with mild to moderate hypertension?
Captopril is an effective and better-tolerated monotherapy for mild to moderate hypertension in the elderly compared to triamterene/hydrochlorothiazide, avoiding adverse renal biochemical changes.
Answers are grounded in this paper and cite their sources.
Both agents lower BP in elderly hypertensives; hypothesis-generating and leaves open optimal first-line choice.
Forty patients over 70 years old with a diastolic blood pressure of 95 to 110 mm Hg and/or a systolic blood pressure of 170 to 220 mm Hg after two weeks' placebo therapy underwent a single-blind, placebo-controlled, randomized cross-over study using captopril and triamterene and hydrochlorothiazide (Dyazide). Blood pressure was lowered from a mean of 189 +/- 2.0/92 +/- 1.7 mm Hg (mean +/- SEM) to 161 +/- 2.8/78 +/- 1.7 mm Hg with captopril therapy, and therapy with triamterene and hydrochlorothiazide produced similar reductions (156 +/- 2.7/78 +/- 1.7 mm Hg). Two patients on triamterene and hydrochlorothiazide therapy withdrew because of side effects, while only minor side effects were observed with captopril therapy. Therapy with triamterene and hydrochlorothiazide produced significant elevation of urea, creatinine, and uric acid, while captopril therapy produced no biochemical or hematologic changes. A single daily dose of captopril alone was sufficient to normalize the blood pressure in 31 (75%) of 40 patients. Captopril appears to be a promising monotherapy for the elderly with mild to moderate hypertension.
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Jean Woo (1987) conducted an RCT in Mild to moderate hypertension (n=40). Captopril vs. Triamterene and hydrochlorothiazide was evaluated on Blood pressure. Captopril normalized blood pressure in 75% of elderly patients (lowering mean BP to 161/78 mm Hg), producing similar reductions to triamterene/hydrochlorothiazide but without biochemical changes.
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