Open AccessCombination of ramipril and hydrochlorothiazide in the treatment of mild to moderate hypertension: Part 1—a double‐blind, comparative, multicenter study in nonresponders to ramipril monotherapy
Author(s) -
Heidbreder D.,
Froer K.L.,
Breitstadt A.,
Cairns V.,
Bender N.,
Langley A.
Publication year - 1992
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960151210
Subject(s) - ramipril , medicine , hydrochlorothiazide , blood pressure , combination therapy , supine position , urology , double blind , placebo , alternative medicine , pathology
In a parallel‐group multicenter study, the efficacy and safety of combination therapy with ramipril 5 mg plus hydrochlorothiazide 25 mg were compared double‐blind with those of 5 mg and 10 mg ramipril monotherapy in patients with mild to moderate hypertension who had not responded adequately to ramipril 5 mg alone. Patients were initially treated single‐blind for 1 week with ramipril 2.5 mg and 3 weeks with ramipril 5 mg. Of 240 patients enrolled, 165 were subsequently classed as nonresponders (diastolic blood pressure > 90 mmHg) and were randomized to one of the three double‐blind treatments for a further 4 weeks. In the double‐blind phase, the mean reductions in supine systolic and diastolic blood pressures at end point were significantly greater in the 5 mg plus 25 mg combination group (11.6/10.6 mmHg) than in the groups receiving ramipril 5 mg (6.2/5.9 mmHg; both p<0.01) and ramipril 10 mg (7.4/7.1 mmHg; both p<0.05). The proportion of responders at end point was also higher for combination therapy (72%) than for monotherapy (48% for ramipril 5 mg and 62% for ramipril 10 mg). All three treatments were well tolerated. Analysis of laboratory values revealed no clinically important changes.