A COMPARISON OF THE ANTIHYPERTENSIVE EFFECTIVENESS OF A COMBINATION OF MOEXIPRIL OR SUSTAINED-RELEASE VERAPAMIL WITH LOW-DOSE HYDROCHLOROTHIAZIDE

The antihypertensive effectiveness of moexipril, a new angiotensin-con verting enzyme (ACE) inhibitor, and sustained-release verapamil (verap amil SR) in combination with low-dose hydrochlorothiazide was investig ated in patients with moderate to severe (Stages II and III) essential hypertension. Of 147 patients treated for 4 weeks with hydrochlorothi azide 25 mg/day 108 patients with sitting diastolic blood pressure (SD BP) of 100 to 114 mmHg were randomly assigned to receive either moexip ril 7.5 mg/day (n = 56) or verapamil SR 180 mg/day (n = 52) in additio n to hydrochlorothiazide 25 mg/day. After 4 weeks of treatment, doses of moexipril or verapamil SR were increased to 15 and 240 mg/day respe ctively for patients with SDBP of greater than or equal to 90 mmHg. Th ese patients were evaluated for an additional 8 weeks. Electrocardiogr ams, blood chemistries, blood counts, urinalysis, plasma renin activit y, and plasma aldosterone levels were monitored during the study. Moex ipril or verapamil SR, in combination with low dose hydrochlorothiazid e, resulted in decreased blood pressure in the sitting and standing po sitions. No correlation between blood pressure response and baseline p lasma renin activity was demonstrated. The results of this study indic ate that both moexipril and verapamil SR produced an additive hyperten sive effect when added to low dose hydrochlorothiazide. These combinat ions were well tolerated by the patients and did not result in serious clinical and metabolic side effects.