A DOUBLE-BLIND RANDOMIZED COMPARISON OF PERINDOPRIL AND KETANSERIN INTHE TREATMENT OF HYPERTENSION IN ELDERLY DIABETIC-PATIENTS

A double-blind, randomised study of the antihypertensive efficacy of p erindopril and ketanserin in 44 elderly noninsulin-dependent diabetic patients aged greater-than-or-equal-to 60 years was conducted. Blood p ressure, blood biochemical and haematological parameters, plasma vasoa ctive hormones, urinary volume, electrolytes and microalbumin were mea sured at baseline, after a 4-week placebo period, and at intervals dur ing 8 weeks of treatment with active drug. Electrocardiogram and echoc ardiogram data were also obtained. Dosages of perindopril used were 2m g once daily for 4 weeks doubling to 4mg once daily if a target blood pressure of less-than-or-equal-to 160/90mm Hg was not reached. Dosages of ketanserin were 40mg twice daily increasing to 80mg twice daily. B oth drugs caused a small but statistically insignificant reduction in blood pressure. Although the response rates (supine systolic blood pre ssure reduction of >10mm Hg) were 54% for perindopril and 45% for keta nserin, target blood pressure (supine blood pressure 160/90mm Hg) was reached in only 21% of perindopril and 20% of ketanserin recipients. P lasma creatinine and 24-hour urine sodium excretion increased in patie nts receiving ketanserin therapy. Glycaemic indices and the lipid prof ile did not change in either group, except for a reduction in plasma t riglycerides in the ketanserin group. No changes in urinary microalbum in, electrocardiogram, or echocardiographic cardiac parameters were ob served. It is concluded that in the present study neither drug provoke d a significant blood pressure lowering effect and that serum creatini ne increased in the ketanserin group.