PERINDOPRIL HYDROCHLOROTHIAZIDE DOSE COMBINATIONS FOR THE TREATMENT OF HYPERTENSION - A MULTICENTER STUDY/

The primary goal of combination therapy is to enhance efficacy without compromising safety. lit this multicenter study, the efficacy and tol erability of perindopril added to continuing hydrochlorothiazide thera py were evaluated in patients with mild to moderate (stage I and II), essential hypertension. Two hundred fifty-two patients with supine dia stolic blood pressure of 95 mmHg to 114 mmHg were treated for 4 weeks with open-label hydrochlorothiazide at 25 mg/day. The 208 patients who se supine diastolic blood pressure was greater than or equal to 90 mmH g at the end of hydrochlorothiazide monotherapy entered a 12-week, dou ble-blind treatment, where placebo or perindopril were added to the 25 -mg/day hydrochlorothiazide therapy as follows: placebo (n = 50) and d oses of perindopril at 2 mg/day (n = 52), 4 mg/day (n = 53), and 8 mg/ day (n = 53). The perindopril-hydrochlorothiazide combinations decreas ed both supine systolic blood pressure and supine diastolic blood pres sure by 10.3/6.7, 9.6/8.0, and 9.3/6.3 mmHg, for perindopril doses of 2, 4, and 8 mg/day, respectively; there was no difference among the th ree drug groups. Placebo decreased blood pressure by 1.6/2.0 mmHg, an effect that was significantly lower compared with perindopril-hydrochl orothiazide combinations. Adverse events were mild and similar among a ll treatment groups, except cough, which was 4.0%, 3.9%, 7.6%, and 13. 2% for placebo and perindopril doses of 2, 4, and 8 mg respectively. T he results of this multicenter study indicate that the combination of perindopril and hydrochlorothiazide is safe and effective in lowering blood pressure. The findings also demonstrate that lower doses of peri ndopril are as effective as higher doses when combined with hydrochlor othiazide.