LISINOPRIL ANT THE COMBINATION OF LISINOP RIL AND HYDROCHLOROTHIAZIDEIN THE TREATMENT OF MILD-TO-MODERATE HYPERTENSION

The main objective of this multicenter study was to compare the effica cy of an increase in dose and of a synergic combination in the 68 pati ents out of 126 (54 %) with hypertension (DBP between 95 and 120 mm Hg after 2 weeks of placebo) who did not respond (DBP greater than or eq ual to 95 mmHg) to a 4-week treatment of 20 mg per day of lisinopril. Patients were randomized to receive a 4-week double-blind treatment of either 40 mg per day of lisinopril or the combination of 20 mg of lis inopril and 12,5 mg of hyfrochlorothiazide per day. Mean reductions of systolic (inter-groupe comparison : p = 0,08) and diastolic BP (p = 0 ,006) as well as the proportion of responders (82 % versus 45 %, p les s than or equal to 0,01) were greater with the lisinopril-hydrochiorot hiazide combination than with 40 mg of lisinopril. Tolerance was good in the 3 groups. The administration of a synergic combination is justi fied when hypertension is not controlled by a monotherapy.