Long-term antihypertensive therapy with captopril.

Area of Science:

• Cardiology
• Pharmacology

Background:

• Hypertension necessitates lifelong treatment, making long-term drug efficacy and safety crucial.
• Investigating the long-term effects of captopril is vital for its continued therapeutic use.

Purpose of the Study:

• To assess the continuing effectiveness and safety of captopril in hypertensive patients over extended periods.
• To evaluate the development of drug tolerance and the incidence of side effects during long-term captopril therapy.

Main Methods:

• A cohort of 7103 hypertensive patients received captopril, with 4397 treated for 3 months to 4 years.
• Long-term patients included those with mild, moderate, severe essential, and renovascular hypertension, often co-treated with diuretics.
• Data collected through repeated examinations to monitor blood pressure control, drug tolerance, side effects, and biochemical parameters.

Main Results:

• No significant drug tolerance was observed in patients on long-term captopril and diuretic therapy.
• Common early side effects like rash and taste disturbances were not problematic long-term; neutropenia was rare.
• Proteinuria occurred in 1.0% of patients, primarily those with pre-existing renal disease on high doses, and was usually reversible.

Conclusions:

• Captopril provides sustained blood pressure control without tolerance in long-term hypertension management.
• The overall 4-year cumulative discontinuance rate for side effects was 11.6%, comparing favorably to other antihypertensives.
• Captopril is a safe and effective option for prolonged hypertension treatment, with manageable side effect profiles.