Prazosin versus captopril as initial therapy. Effect on hypertension and lipid levels

A randomized, parallel group study evaluated the safety, efficacy, and effect of the alpha blocking agent prazosin and the angiotensin converting enzyme inhibitor captopril on serum lipid levels in patients with mild to moderate hypertension. Baseline evaluations were performed on 31 patients after a four-week placebo washout period. Patients were randomly assigned to receive either prazosin (n = 15) or captopril (n = 16). Daily doses were titrated as follows: for prazosin, 1 mg two times daily to maximum of 20 mg per day; for captopril, 25 mg three times daily to a maximum of 450 mg per day. If diastolic blood pressure was not adequately controlled (less than 85 mm Hg) after four weeks of monotherapy, 1 mg of polythiazide was added to the daily regimen. There were no statistically significant differences between the drug groups for the measured variables in either the parallel or crossover phase of the study. Five of 15 prazosin-treated patients and six of 16 captopril-treated patients required the addition of thiazide to achieve blood pressure control.