Antihypertensive Effectiveness of a Very Low Fixed-Dose Combination of Moexipril and Hydrochlorothiazide

The antihypertensive and metabolic effects of a fixed combination of very low dose of moexipril (MO), an angiotensin-converting enzyme (ACE) inhibitor, and hydrochlorothiazide (HCTZ) were tested in a multicenter, placebo (PBO) controlled, double-blind, parallel study of men (M) and women (W) with mild to moderate essential hypertension. After 4 weeks of PBO treatment, 223 patients with sitting diastolic blood pressure (SDBP) of 95-114 mm Hg and sitting systolic blood pressure (SSBP) < or =200 mm Hg, inclusive, were randomized to PBO (114 patients: M, 56; W, 58) and MO/HCTZ 3.75/6.25 mg (109 patients: M, 58; W, 51) given once daily and followed up for 12 weeks. The fixed combination MO/HCTZ, 3.75/6.25 mg, reduced SSBP/SDBP -7.6/-7.6 mm Hg (M, -8.5/-8.0; W, -6.3/-7.0), versus PBO, +0.2/-3.9 mm Hg (M, -1.9/-3.4; W, +1.1/-4.4); p < 0.05. Also, 54% of patients receiving MO/HCTZ, 3.75/6.25 mg/day, had good blood pressure response (SDBP < or =90 mm Hg, or > or =10 mm Hg decrease from baseline), versus 28% for PBO (p < 0.001). The clinical and metabolic side effects were minor and not different between MO/HCTZ and PBO. The results of this study indicate (a) a once-daily very low dose fixed combination of MO/HCTZ is effective and well tolerated by men and women with mild to moderate essential hypertension; (b) it is almost devoid of clinical and metabolic side effects; and (c) the safety profile was similar in men and women.