Clinical aspects of antihypertensive therapy with urapidil. Comparison with hydrochlorothiazide

To define the efficacy and tolerability of urapidil as a monotherapy in ambulatory patients with hypertension, we compared urapidil with a standard first-line antihypertensive agent, hydrochlorothiazide (HCT), in a multicentre general practice trial. The study was an 8-week double-blind randomised parallel-group comparison, with a 3-week pretreatment phase (1 week of gradual reduction of antihypertensive agents, 2 weeks of placebo). Blood pressure and heart rate were monitored using an automatic device (boso-digital S II), in the morning after the last intake of medication in the evening before. The dosages of urapidil used were 30mg, 60mg or 90mg twice daily; the dosages of HCT were 12.5 mg/day or 12.5 or 25mg twice daily. If necessary, dosage adjustments were performed every 2 weeks. Data from 165 patients could be evaluated (urapidil, n = 78; HCT, n = 87). Sitting blood pressure was reduced significantly, by 9.4/7.1 mm Hg with urapidil and by 20.7/11.2 mm Hg by HCT. The effect of HCT on systolic (p less than 0.001) and diastolic (p less than 0.05) blood pressure was significantly more pronounced than that of urapidil. The response rates (diastolic blood pressure decreased to less than or equal to 90mm Hg or by greater than or equal to 10mm Hg) were 36% of patients with urapidil and 56% with HCT. Heart rate was not significantly affected by either treatment.(ABSTRACT TRUNCATED AT 250 WORDS)