| Blood pressure-lowering efficacy of amiloride versus enalapril as add-on drugs in patients with uncontrolled blood pressure receiving hydrochlorothiazide. | |
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MedLine Citation:
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PMID: 18855259 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A large proportion of patients with hypertension need a second drug to reach satisfactory control of blood pressure (BP), but there are few well-designed controlled trials comparing the efficacy of drugs added as a second option. In a double-blind randomized clinical trial, 82 patients with uncontrolled BP, receiving hydrochlorothiazide 25 mg daily, were selected to receive amiloride 2.5-5 mg/day (n = 39) or enalapril 10-20 mg/day (n = 43). Ambulatory blood pressure monitoring (ABPM) was done before and after 12-weeks of treatment. Office BP was measured in the 4(th), 8(th), and 12(th) weeks. The doses of amiloride and enalapril were doubled in the fourth week, and propranolol was added in the 8th week if office BP was above 140/90 mm Hg. There was a greater BP reduction in patients treated with enalapril. The ABPM delta values between the groups were 3.6 +/- 2.2, 3.9 +/- 2.2, and 1.1 +/- 2.7 mmHg for 24-h, daily, and nightly systolic blood pressure, respectively, favoring enalapril. For diastolic blood pressure (DBP), the deltas were 1.7 +/- 2.0, 3.2 +/- 1.5, and 1.2 +/- 1.9 mmHg, respectively (p = 0.039 for daily DBP). Office SBP decreased more and sooner in patients allocated to enalapril (p = 0.003). More patients taking amiloride required propranolol to control BP (p = 0.035). Potassium increased 0.3 mEq/L on the average in both groups. Cough, albeit predominantly mild, was reported more frequently by participants treated with enalapril. We conclude that enalapril is more effective than amiloride to lower BP of patients on hydrochlorothiazide with uncontrolled BP. |
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Authors:
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Patrícia Guerrero; Flávio D Fuchs; Leila M Moreira; Vítor M Martins; Carolina Bertoluci; Sandra C Fuchs; Miguel Gus |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Clinical and experimental hypertension (New York, N.Y. : 1993) Volume: 30 ISSN: 1525-6006 ISO Abbreviation: Clin. Exp. Hypertens. Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-15 Completed Date: 2009-01-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9305929 Medline TA: Clin Exp Hypertens Country: United States |
Other Details:
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Languages: eng Pagination: 553-64 Citation Subset: IM |
Affiliation:
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Graduate Study Program in Health Sciences-Cardiology, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil. |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00394394 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Amiloride / administration & dosage* Angiotensin-Converting Enzyme Inhibitors / administration & dosage Antihypertensive Agents / administration & dosage* Blood Pressure / drug effects Blood Pressure Monitoring, Ambulatory Diuretics / administration & dosage Double-Blind Method Drug Therapy, Combination Enalapril / administration & dosage* Female Humans Hydrochlorothiazide / administration & dosage* Hypertension / drug therapy*, physiopathology Male Middle Aged Sodium Channel Blockers / administration & dosage |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Diuretics; 0/Sodium Channel Blockers; 2609-46-3/Amiloride; 58-93-5/Hydrochlorothiazide; 75847-73-3/Enalapril |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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