Document Detail


Placebo-controlled comparison of captopril, metoprolol, and hydrochlorothiazide therapy in non-insulin-dependent diabetic patients with primary hypertension.
MedLine Citation:
PMID:  1581012     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The antihypertensive effect of captopril, metoprolol, and hydrochlorothiazide was compared in 23 non-insulin-dependent (NIDDM) diabetic patients less than or equal to 75 years of age, with borderline to moderate primary hypertension. In a double blind, placebo-controlled cross-over trial the patients were treated with 25 to 50 mg captopril, 50 to 100 mg metoprolol, 12.5 to 25 mg hydrochlorothiazide, and placebo, each given twice daily for 8 weeks. Antidiabetic treatment remained unchanged during the study. After receiving placebo for a 4 week run-in period, arterial blood pressure was 168/101 +/- 93/10 (mean +/- SEM) mm Hg. Diastolic blood pressure was lowered significantly during all active treatment periods compared to the placebo value of 97 +/- 2 mm Hg: captopril, 92 +/- 1 mm Hg; metoprolol, 90 +/- 1 mm Hg; hydrochlorothiazide, 91 +/- 1 mm Hg. Metabolic variables were not significantly altered by captopril and metoprolol, while hydrochlorothiazide treatment increased hemoglobin A1c from 7.5 +/- 0.3 to 8.2 +/- 0.4% (P less than .001), decreased high-density lipoprotein-cholesterol from 1.19 +/- 0.08 to 1.10 +/- 0.06 mmol/L (P less than .05). Glomerular filtration rate, urinary albumin excretion, orthostatic blood pressure response, and digital systolic blood pressure in the lower limb remained unchanged during the active treatment periods. The frequency of subjective adverse effects was acceptable during active treatment and not significantly different compared to placebo. We conclude that antihypertensive treatment for 8 weeks with captopril or metoprolol in NIDDM patients is well-tolerated and causes no deterioration in metabolic control and kidney function, while hydrochlorothiazide causes a slight deterioration in glycemic control and lipid profile.
Authors:
M A Gall; P Rossing; P Skøtt; E Hommel; E R Mathiesen; L U Gerdes; M Lauritzen; A Vølund; O Faergeman; H Beck-Nielsen
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of hypertension     Volume:  5     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  1992 May 
Date Detail:
Created Date:  1992-06-18     Completed Date:  1992-06-18     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  257-65     Citation Subset:  IM    
Affiliation:
Steno Memorial and Hvidöre Hospital, Klampenborg, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Aged
Captopril / therapeutic use*
Diabetes Mellitus, Type 2 / diet therapy,  drug therapy,  physiopathology*
Double-Blind Method
Female
Glomerular Filtration Rate / drug effects
Humans
Hydrochlorothiazide / adverse effects,  therapeutic use*
Hypertension / drug therapy*,  physiopathology
Hypoglycemic Agents / antagonists & inhibitors
Lipids / blood
Male
Metoprolol / therapeutic use*
Middle Aged
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Lipids; 37350-58-6/Metoprolol; 58-93-5/Hydrochlorothiazide; 62571-86-2/Captopril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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