Sg. Chrysant et M. Stimpel, A COMPARISON OF THE ANTIHYPERTENSIVE EFFECTIVENESS OF A COMBINATION OF MOEXIPRIL OR SUSTAINED-RELEASE VERAPAMIL WITH LOW-DOSE HYDROCHLOROTHIAZIDE, Journal of clinical pharmacology, 36(8), 1996, pp. 701-706
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.