January 1, 1988American Journal of Hypertension
Controlled Trial of Enalapril and Hydrochlorothiazide in 200 Hypertensive Patients
Why the study?
Does adding hydrochlorothiazide (12.5 mg or 25 mg) improve blood pressure reduction in patients with essential hypertension not controlled on enalapril alone?
Population
200 patients with essential hypertension, multicenter, multinational. The randomized cohort consisted of 125…
Comparison
Hydrochlorothiazide 12.5 mg/day or 25 mg/day… vs Placebo added to background enalapril for 4 weeks.
Design
RCT, randomized, double-blind
Follow-up
4 weeks (post-randomization)
Authors
Discussion
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Implication
Supports adding low-dose hydrochlorothiazide to enalapril for uncontrolled hypertension; extends RCT evidence on combination therapy.
Structured PICO
Does adding hydrochlorothiazide (12.5 mg or 25 mg) improve blood pressure reduction in patients with essential hypertension not controlled on enalapril alone?
P
Population
200 patients with essential hypertension (DBP 100 to 120 mm Hg after a 2- to 4-week placebo period), multicenter, multinational. The randomized cohort consisted of 125 patients whose DBP remained >90 mm Hg after 6 weeks of enalapril monotherapy.
I
Intervention
Hydrochlorothiazide 12.5 mg/day or 25 mg/day added to background enalapril (20 mg/day) for 4 weeks.
C
Comparator
Placebo added to background enalapril (20 mg/day) for 4 weeks.
O
Outcome
Change in blood pressure and proportion of patients reaching DBP ≤ 90 mm Hg at 4 weeks.surrogate
Adding low-dose hydrochlorothiazide (12.5 mg/day) to enalapril effectively lowers blood pressure in patients with essential hypertension not controlled by enalapril alone, with fewer potassium reductions than a 25 mg/day dose.
Cite This Study
Dahlöf et al. (1988) studied this question.