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Captopril in the treatment of hypertension associated with claudication
Insights
Captopril significantly improved blood flow and reduced pain in hypertensive patients with peripheral vascular disease. This suggests captopril is an effective treatment for hypertension alongside leg circulation issues.
Area of Science:
- Cardiology
- Vascular Medicine
- Pharmacology
Background:
- Hypertension and peripheral vascular disease (PVD) often coexist, complicating patient management.
- Lower limb PVD, specifically Fontaine stages IIa and IIb, impacts patient mobility and quality of life.
- Effective treatment requires addressing both elevated blood pressure and impaired limb circulation.
Purpose of the Study:
- To evaluate the efficacy of captopril in hypertensive patients with peripheral vascular disease.
- To compare captopril's effects against chlorthalidone in this patient population.
- To assess captopril's impact on hemodynamic parameters and exercise tolerance.
Main Methods:
- A study involving 40 hypertensive patients (WHO stages I-II) with lower limb PVD (Fontaine stages IIa-IIb).
- Initial phase: 20 patients randomized to 8 weeks of either chlorthalidone (25 mg/day) or captopril (50 mg BID).
- Second phase: 20 additional patients received 8 weeks of captopril (50 mg BID).
- Measurements included blood pressure, heart rate, ankle/arm pressure index (API) at rest and post-exercise, and pain-free intervals.
Main Results:
- Captopril treatment led to statistically significant improvements in API at rest and post-exercise (P<0.05 to P<0.001).
- Significant increases in absolute pain-free intervals (P<0.05 to P<0.001) and systolic blood pressure were observed with captopril.
- Captopril also improved diastolic blood pressure and relative pain-free intervals in the second patient group (P<0.001).
- Chlorthalidone did not yield statistically significant improvements in the initial comparative phase.
Conclusions:
- Captopril demonstrates efficacy in improving limb blood flow in patients with vascular disease.
- The drug effectively manages hypertension in patients experiencing claudication.
- Captopril appears to be a safe and effective therapeutic option for hypertension associated with peripheral vascular disease.
Abstract:
The effect of captopril was studied in 40 hypertensive patients (WHO stages I and II) with peripheral vascular disease of the lower limbs (Fontaine stages IIa and IIb). We assessed systolic and diastolic arterial pressure, heart rate in supine and upright position, relative and absolute pain free intervals, and ankle/arm pressure index at rest and after treadmill exercise test. In the first part of the study 20 patients were divided into two groups, one of which was treated with chlorthalidone (25 mg/day) and the other with captopril (50 mg two times a day) for 8 weeks. Statistically significant improvements were only obtained in the captopril-treated group. They concerned the ankle/arm pressure index at rest (P less than 0.05) and after exercise (P less than 0.05) and the absolute pain free interval (P less than 0.05) as well as systolic arterial pressure. Furthermore, 20 more patients were treated with captopril (50 mg two times a day) for 8 weeks, and improvements were found in ankle/arm pressure index at rest (P less than 0.01) and after exercise (P less than 0.001) and in relative and absolute pain free intervals (P less than 0.001) as well as in systolic and diastolic arterial pressure. These results indicate an increase in flow to the limbs of patients with vascular disease treated with captopril, and suggest that captopril is an effective drug without contraindications for the treatment of hypertension associated with claudication.