B. Hofling et al., COMPARISON OF THE EFFICACY AND SAFETY OF DILTIAZEM AND CAPTOPRIL IN MILD-TO-MODERATE ESSENTIAL-HYPERTENSION, Herz, Kreislauf, 26(9), 1994, pp. 295-299
This 12-week, double-blind multicenter study was performed to compare
the efficacy and safety of the calcium antagonist diltiazem and the AC
E inhibitor captopril in patients with mild to moderate stable essenti
al hypertension. Following a 2-week placebo-washout phase, 58 outpatie
nts with diastolic blood pressure greater-than-or-equal-to 95 mmHg and
< 115 mmHg were randomly assigned to a therapy with either diltiazem
180 mg once daily (n = 27) or captopril 50 mg once daily (n = 31). The
average age was 57 years in both groups. If diastolic blood pressure
was still higher than 90 mmHg after 2 weeks, the dose was to be titrat
ed to diltiazem 270 mg daily or captopril 75 mg daily, respectively. 2
2 patients of the diltiazem and 30 patients of the captopril group com
pleted the study. Efficacy was evaluated using 24-h ambulatory blood p
ressure monitoring (ABPM) measurements. The mean 24-h baseline value o
f diastolic blood pressure was 93 mmHg in both treatment groups, and w
as reduced by a mean of 6.8 mmHg with both forms of therapy. While for
the average reduction of the 24-h blood pressure no differences betwe
en the treatment groups were found, the mean baseline value of day-tim
e diastolic blood pressure of 97 mmHg in both groups was reduced by 7.
7 mmHg in the diltiazem and by 4.0 mmHg in the captopril group, and th
e mean night-time diastolic blood pressure of 85 mmHg in both groups w
as reduced by 5.0 mmHg in the diltiazem and by 8.1 mmHg in the captopr
il group. A total of four patients in the diltiazem group reported sev
en adverse events, all resulting in withdrawal from the study. No adve
rse events were reported in the captopril group. In conclusion, diltia
zem and captopril showed comparable reductions in mean 24-h blood pres
sure, but relatively marked differences for the day- and night-time va
lues. Possibly, that may be an advantage of diltiazem. According to th
e results of this study, the tolerability of captopril seems to be som
ewhat better than that of diltiazem.