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[Antihypertensive effects of captopril, hydrochlorothiazide, alone or in combination, with different categories of
N Senn1, J P Ollivier, J P Abitbol
1INSERM U 7, hôpital Necker, Paris.
Abstract:
30 male essential hypertensive patients were submitted to a "washout" of 8 days and at D (0) divided into two groups receiving 25 mg/day of Hydrochlorothiazide or 50 mg/day of Captopril. At D (45) the treatment was crossed, at D (90) all the patients received both drugs and at D (135) the treatment was stopped. According to the antihypertensive response, the patients were divided into: (i) R: responders, PAS (systolic arterial pressure) less than or equal to 140 mmHg and PAD (diastolic) less than or equal to 90 mmHg, ii) M: moderate responders, 140 less than PAS less than or equal to 160 mmHg and/or 90 less than PAD less than or equal to 100 mmHg and (iii) F: therapeutic failure, PAS greater than 160 mmHg and/or PAD greater than 100. A parallel study was carried out in erythrocytes. At D (0), 40 ml of blood were drawn and the hypertensive patients were classified in: (i) (+)NaT patients, 19 patients having one or more of the following erythrocyte abnormalities: increased Na+: Li+ counter-transport, increased Na+ leak, decreased affinity of the Na+, K+-pump and/or Na+, K+ cotransport system for internal Na+ and (ii) (-)NaT patients, 11 patients without the above erythrocyte abnormalities. During monotherapy treatment (with captopril or hydrochlorothiazide) 8 out of 11 (-)NaT patients normalized blood pressure (responders) against only 5 out of 19 (+)NaT patients (p less than 0.05, chi 2 test).(ABSTRACT TRUNCATED AT 250 WORDS)