[Efficacy of benazepril after failure of the first antihypertensive treatment]

The aim of the study was to evaluate efficacy of benazepril prescribed as replacement therapy in patients with mild to moderate hypertension, according to the pharmacological class of the previous unsuccessful drug. After wash-out of the ineffective or badly tolerated medication, 814 patients were randomly and blindly assigned to receive either benazepril 10 mg (group 1), benazepril 20 mg (group 2) or benazepril 10 mg plus hydrocholorothiazide 12.5 mg (group 3) once daily. The mean DBP changes from baseline were highly significant in each group (p < 0.001), and greater in groups 2 and 3 versus group 1 (p = 0.003). There was a non-significant trend for a greater efficacy of benazepril when the previous therapy was a diuretic or a calcium inhibitor. In this study, benazepril appears to be efficient as replacement therapy in moderate hypertension, but no link was demonstrated between the quality of the result and the nature of the previous drug.