ACE-INHIBITION WITH PERINDOPRIL IN ESSENTIAL HYPERTENSIVE PATIENTS WITH CONCOMITANT DISEASES

PURPOSE: Many hypertensive patients have other, usually long-term dise ases. Antihypertensive therapy may interfere with these diseases and t heir therapies. In the present study, the possible interactions of the ACE-inhibitor perindopril with several of the most common long-term d iseases was evaluated. PATIENTS AND METHODS: In a multicenter, double- blind, randomized, placebo-controlled trial, the effect of perindopril was evaluated in 490 patients with mild essential hypertension and an y one of the following concomitant diseases: hyperlipidemia, type II d iabetes mellitus, ischemic heart disease, cardiac arrhythmia, peripher al arterial occlusive disease, nephropathy with proteinuria, chronic o bstructive pulmonary disease, or degenerative joint disease treated wi th nonsteroidal anti-inflammatory drugs (NSAIDs). After a 3-week singl e-blind placebo run-in, the patients received either perindopril (4 mg /d) or matching placebo for 6 weeks. RESULTS: Blood pressure was effec tively reduced by perindopril irrespective of the associated disease. The rate of spontaneously reported side effects was low. Treatment wit h perindopril was free from adverse interactions with the concomitant diseases and therapies. Moreover, favorable actions could be observed in patients with ischemic heart disease (reduction of maximal ST-segme nt depression during peak exercise and decrease in the number of angin a attacks), in patients with proteinuria (decrease in albuminuria in p atients with normal serum creatinine levels), and in patients with NSA ID-treatment (increase in prostaglandin E(2) concentration in gastric mucosa suggesting gastric cytoprotection). CONCLUSION: This trial show s that ACE-inhibition with perindopril represents a simple, safe, and effective short-term therapeutic option for the large proportion of pa tients with mild essential hypertension and concomitant diseases and t herapies.