May 1, 1992American Journal of Hypertension
Placebo-Controlled Comparison of Captopril, Metoprolol, and Hydrochlorothiazide Therapy in Non - Insulin-Dependent Diabetic Patients With Primary Hypertension
Why the study?
Does captopril, metoprolol, or hydrochlorothiazide effectively lower blood pressure without causing metabolic deterioration in NIDDM patients with primary hypertension?
Population
23 non-insulin-dependent diabetic patients ≤75 years of age, with borderline to moderate primary hypertension.
Comparison
Captopril 25 to 50 mg, metoprolol 50 to 100 mg… vs Placebo given twice daily for 8 weeks, with…
Design
RCT, double blind, placebo-controlled
Follow-up
8 weeks per treatment period
Authors
Discussion
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Implication
Supports preferring captopril or metoprolol over hydrochlorothiazide in hypertensive NIDDM; confirms metabolic neutrality of the former in this population.
Structured PICO
Does captopril, metoprolol, or hydrochlorothiazide effectively lower blood pressure without causing metabolic deterioration in NIDDM patients with primary hypertension?
P
Population
23 non-insulin-dependent (NIDDM) diabetic patients ≤75 years of age, with borderline to moderate primary hypertension.
I
Intervention
Captopril 25 to 50 mg, metoprolol 50 to 100 mg, or hydrochlorothiazide 12.5 to 25 mg, each given twice daily for 8 weeks.
C
Comparator
Placebo given twice daily for 8 weeks (cross-over design), with antidiabetic treatment remaining unchanged.
O
Outcome
Diastolic blood pressuresurrogate
In NIDDM patients with hypertension, captopril and metoprolol effectively lower blood pressure without adverse metabolic effects, whereas hydrochlorothiazide worsens glycemic control and lipid profiles.
Cite This Study
Gall et al. (1992) studied this question.