EFFECTS OF FOSINOPRIL ON RENAL-FUNCTION IN PATIENTS WITH MILD-TO-MODERATE ESSENTIAL-HYPERTENSION

In a 10-week double-blind randomised placebo-controlled trial, the eff icacy, safety and effect on renal function of a single dose of fosinop ril 20mg once daily were studied in 23 patients with mild to moderate essential hypertension. After discontinuation of previous antihyperten sive treatment and a 4-week washout period, all patients received plac ebo for the next 2 weeks. Patients were then randomly assigned, in a d ouble-blind fashion, to 1 of 2 groups: the first group (group F) was m ade up of 12 patients who received fosinopril 20mg once daily; the sec ond group (group PL) was made up of 11 patients who received one match ing placebo tablet once daily. The duration of treatment was 4 weeks. At the end of the placebo period and after 4 weeks' treatment, systoli c blood pressure (SBP), diastolic blood pressure (DBP) and heart rate were measured, routine blood and urine investigations performed, and p lasma renin activity (PRA), plasma aldosterone and renal haemodynamics determined. A statistically significant reduction in both SBP (p < 0. 001) and DBP (p < 0.001) was observed only in group F, 4 weeks after i nitiation of treatment. Heart rate remained unchanged and there were n o adverse events in either group. In group F, PRA increased significan tly (p < 0.05) and glomerular filtration rate remained unchanged; rena l blood flow was significantly reduced (p < 0.01), although it remaine d within the normal limits. In conclusion, fosinopril demonstrated an adequate antihypertensive effect and was well tolerated, without any s ignificant changes in renal haemodynamics.