Comparative evaluation of captopril and methyldopa monotherapy for hypertension: double-blind study in Indians

A double-blind, parallel-group study was conducted in 41 Indian men and women with hypertension to compare the antihypertensive effects of captopril and methyldopa. Twenty patients received 150 mg of captopril and 21 patients received 750 mg of methyldopa daily. The drugs were administered in three equally divided doses for four weeks. Blood pressure was measured after one, two, and four weeks of therapy. Relevant clinical and biochemical investigations were carried out before and after treatment. Sixteen patients given captopril and 11 given methyldopa responded to therapy. Among the captopril responders, initial mean systolic blood pressure (+/- SE) was 155 +/- 5.0 mmHg and diastolic blood pressure was 105 +/- 2.1 mmHg. These values were reduced to 119 +/- 9.8 and 80 +/- 6.1 mmHg, respectively, after four weeks of therapy. Similarly, among the methyldopa responders, initial mean systolic blood pressure was 180 +/- 7.4 mmHg and diastolic blood pressure was 112 +/- 3.8 mmHg. These values were reduced to 138 +/- 7.0 and 92 +/- 3.8 mmHg, respectively, after four weeks of therapy. The fall in the blood pressure in both groups was highly significant (P less than 0.001). None of the patients in either group had any clinically significant side effects. The results of this study suggest that monotherapy with captopril may be more effective than monotherapy with methyldopa in Indian hypertensives.