Captopril versus perindopril: a double blind study in essential hypertension

Area of Science:

• Cardiology
• Pharmacology
• Clinical Trials

Background:

• Essential hypertension management requires effective therapeutic strategies.
• Angiotensin-converting enzyme (ACE) inhibitors are a cornerstone in hypertension treatment.
• Comparing the efficacy of different ACE inhibitors is crucial for clinical practice.

Purpose of the Study:

• To compare the therapeutic efficacy and acceptability of perindopril and captopril in patients with essential hypertension.
• To evaluate the blood pressure-lowering effects of perindopril versus captopril.
• To assess treatment outcomes including monotherapy and combination therapy with hydrochlorothiazide.

Main Methods:

• Double-blind, parallel-group, multicentre clinical trial.
• 165 patients with essential hypertension randomized to perindopril (4 mg once daily) or captopril (25 mg twice daily) after placebo.
• Monthly assessments over three months with dose adjustments and addition of hydrochlorothiazide for uncontrolled blood pressure.

Main Results:

• Perindopril group had higher pretreatment diastolic blood pressure but similar demographics.
• No significant difference in withdrawals or side effects between perindopril and captopril groups.
• Perindopril achieved a significantly higher 'control' rate (75% vs 57%, P=0.016) and a greater fall in diastolic blood pressure (26.5 mmHg vs 18.9 mmHg, P=0.005).

Conclusions:

• Perindopril was more effective than captopril in lowering diastolic blood pressure in essential hypertension.
• Perindopril demonstrated superior efficacy as monotherapy and in combination with hydrochlorothiazide.
• The study supports perindopril as a more potent antihypertensive agent compared to captopril at the studied doses.