QUINAPRIL IN THE TREATMENT OF HYPERTENSION IN PRIMARY-CARE CENTERS

A multicenter, open, prospective study was carried out to establish th e efficacy and safety of quinapril 10.0, 20.0, or 40.0 mg, or 20 mg pl us 12.5 mg hydrochlorothiazide (HCTZ) given once daily in 256 patients with mild-to-moderate essential hypertension treated in primary care units in Mexico. The study consisted of a 4-week placebo washout perio d, followed by 12 weeks of active treatment. Quinapril doses were titr ated upward at 4-week intervals to three dosage levels. Patients who d id not respond to 20-mg doses were randomly assigned to receive 40 mg quinapril daily or 20 mg quinapril plus 12.5 mg HCTZ daily until the e nd of the study. Quinapril was useful as monotherapy in 78% of the 256 patients (92.9% of patients who completed the study were evaluable): 73.3% of patients required only 10 mg, and their average blood pressur e was similar to that of patients who required doses of greater than 1 0 mg. Only 12.2% of responsive patients required either 40 mg of quina pril or 20 mg of quinapril plus HCTZ 12.5 mg. Quinapril was equally ef fective and safe in elderly patients (>60 years old) and in obese and nonobese patients. A low incidence of adverse effects in our patients confirms quinapril's safety, and no adverse changes were observed in l aboratory tests.