INFLUENCE OF BENAZEPRIL AND CAPTOPRIL ON BLOOD-PRESSURE, GLUCOCORTICOIDS AND PROGESTERONE IN ESSENTIAL HYPERTENSIVES

The antihypertensive activity and the influence of adrenal cortex horm ones of benazepril versus captopril were studied in 30 essential hyper tensives in a double-blind, randomised, placebo-controlled trial durin g eight weeks of treatment. Patients started with 50 mg of captopril o r 10 mg of benazepril once daily; if normotension had not been obtaine d after four weeks of treatment the doses were increased to 50 mg twic e daily or 20 mg once daily, respectively. 11-oxycorticosteroids and p rogesterone in males were measured in blood and daily urine at baselin e and at the 4th and the 15th days of drug administration, as well as aldosterone in daily urine by radioimmunoassay, and compared with thes e data in 15 healthy subjects. Following eight weeks of treatment in 6 4% and 56% of patients treated with benazepril and captopril respectiv ely, blood pressure was normalised. In the corresponding remaining 14% and 13%, diastolic blood pressure decreased by 10 mmHg and more but n ot below 90 mmHg. Before treatment excretion of 11-oxycorticosteroids, progesterone and aldosterone was significantly increased without chan ges in blood levels. After two weeks of treatment 11-oxycorticosteroid s and aldosterone excretion decreased (P< 0.05) without progesterone c hanges, benazepril treatment being more effective in decreasing 11-oxy corticosteroids levels in blood (P< 0.05). In patients with high pretr eatment levels of 11-oxycorticosteroids in urine we have noticed the h ighest antihypertensive effect of both drugs. The main conclusions are that both the ACE inhibitors are effective in mild to moderate essent ial hypertensives and might decrease glucocorticoids in urine and bloo d.