Low-dose captopril for the treatment of mild to moderate hypertension

Short-term results of this double-blind control trial (previously reported) in patients with initial diastolic blood pressures (DBP) in the range of 92-109 mm Hg indicated that doses of 12.5 or 25 mg captopril (C) three times daily (t.i.d.) and 37.5 mg twice daily (b.i.d.) had similar antihypertensive effectiveness as 50 mg t.i.d. After 7 weeks of C, the addition of hydrochlorothiazide (H) to two-thirds of the patients enhanced the antihypertensive response. This report presents the results of unchanged and uninterrupted treatment for 9.5 months in 46 patients taking C alone, and for 7.8 months in 94 patients taking C plus H or H alone. With C alone, reductions in DBP averaged 8.3, 11.0, 15.1, and 17.5 mm Hg with the 12.5, 25, 37.5, and 50 mg doses respectively. The response to the 12.5 mg dose only was significantly less than the 50 mg dose. With H alone, the reduction in DBP averaged 10.6 mm Hg and with C plus H reductions averaged 15.6, 18.1, 16.8, and 18.7 mm Hg with the 12.5, 25, 37.5, and 50 mg doses of C, respectively. Reductions in DBP with C plus H regimens were significantly different from H alone. There was no waning of effectiveness from short to long term except for the 12.5 mg dose of C alone. During the long-term phase, two patients developed rash and one lost the sense of taste. Neutropenia in one patient probably was not drug-related. There were no terminations for elevated DBP greater than 104 mm Hg on two successive visits.(ABSTRACT TRUNCATED AT 250 WORDS)