Lisinopril-hydrochlorothiazide combination vs lisinopril for the treatment of hypertension

This multicentre, double-blind, randomized, parallel-group study compared the antihypertensive effect of a once-daily fixed-dose combination of lisinopril 20 mg and hydrochlorothiazide 12.5 mg (L/HCTZ) with that of lisinopril 40 mg once-daily (L40), in patients uncontrolled (supine DBP greater than or equal to 91 mm Hg) on lisinopril 20 mg once daily (L20). After 8 weeks of treatment the supine and standing BPs 4-6 hours post dose were 2.7/1.3 mm Hg lower in the L/HCTZ patients than in the L40 patients. However, thee differences did not reach statistical significance. When measured 24-26 hours post dose, no significant difference was observed between the two treatments with respect to change from baseline for supine and standing BPs. There was no significant difference between treatments. Adverse events related to treatment were reported in 13.2% of L/HCTZ and 20.0% of L40 patients (difference not statistically significant), and withdrawals from L/HCTZ and L40 (1.1% and 2.2%) were not significantly different. The results indicate that in patients uncontrolled on L20, switching to L/HCTZ is as effective as increasing the dose of lisinopril to 40 mg once daily.