What question did this study set out to answer?

February 1, 1987British Journal of Clinical PharmacologyOpen Access

Determination of the optimal dosage regimen of captopril + hydrochlorothiazide in the treatment of moderate arterial hypertension.

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Why the study?

Does captopril plus hydrochlorothiazide reduce blood pressure in patients with mild hypertension?

Population

111 patients with mild hypertension

Comparison

Captopril plus hydrochlorothiazide at three… vs Placebo

Design

RCT, double-blind

Follow-up

6 weeks

Authors

DSD SteruInstitut des Textes et Manuscrits Modernes MCMargaret ChildsUniversity of Vienna SLSylvie LancrenonArtelia (France)

Discussion

Member takes

Implication

Supports 50/25 mg captopril-HCTZ as preferred regimen for mild hypertension; extends dose-optimization data for fixed combinations in RCTs.

Key Points

Determine the optimal therapeutic dose of a 2:1 fixed combination of captopril and hydrochlorothiazide compared to placebo for treating mild hypertension.
Conducted a 6-week, multicenter, double-blind, randomized trial evaluating three dose levels against placebo in 111 patients with mild hypertension.
Assigned patients to placebo (n=27), captopril 25 mg plus hydrochlorothiazide 12.5 mg (n=26), captopril 50 mg plus hydrochlorothiazide 25 mg (n=25), or captopril 100 mg plus hydrochlorothiazide 50 mg (n=33).
All active regimens achieved greater blood pressure reductions than placebo, with the proportion of normalized patients (diastolic blood pressure ≤ 90 mm Hg) or responders (≥ 10% diastolic blood pressure drop) increasing across dosage levels.
At Day 21, blood pressure reduction with the 50/25 mg regimen was comparable to the 100/50 mg regimen and greater than the 25/12.5 mg regimen; by Day 42, all three active dosages produced similar antihypertensive effects.
The 100/50 mg combination produced a higher incidence of adverse events than the lower doses, identifying the 50/25 mg formulation as the optimal regimen for efficacy and tolerability.

Structured PICO

Does captopril plus hydrochlorothiazide reduce blood pressure in patients with mild hypertension?

Population

111 patients with mild hypertension

Intervention

Captopril plus hydrochlorothiazide (HCTZ) at three doses: 25 mg/12.5 mg, 50 mg/25 mg, and 100 mg/50 mg

Comparator

Placebo

Outcome

Fall in blood pressure and percentage of patients normalized (DBP <= 90 mm Hg) or good responders (10% fall in DBP)surrogate

A 50/25 mg combination of captopril and hydrochlorothiazide provides optimal blood pressure reduction with better tolerance than higher doses in mild hypertension.

Cite This Study

Steru et al. (1987) studied this question.

synapsesocial.com/papers/6a7055c52fdcb5703edb5aa2 https://doi.org/10.1111/j.1365-2125.1987.tb03123.x

Topics

Hypertension management

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Implication

Supports 50/25 mg captopril-HCTZ as preferred regimen for mild hypertension; extends dose-optimization data for fixed combinations in RCTs.

Determination of the optimal dosage regimen of captopril + hydrochlorothiazide in the treatment of moderate arterial hypertension.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Determination of the optimal dosage regimen of captopril + hydrochlorothiazide in the treatment of moderate arterial hypertension.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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