TREATMENT OF ESSENTIAL HIGH BLOOD-PRESSUR E WITH HYPERCHOLESTEROLEMIA- EFFECTS OF AN ALPHA-ADRENERGIC BLOCKER AND AN INHIBITOR OF THE ANGIOTENSIN-CONVERTING ENZYME

BACKGROUND: Hypertension and hypercholesterolemia are frequently assoc iated with this leading to considerable cardiovascular risk. METHODS: An open parallel randomized study was performed in which the effects o f doxazosin, an alpha-adrenergic blocker and enalapril, an inhibitor o f the angiotensin converting enzyme were compared in 70 patients with essential high blood pressure and plasma cholesterol levels greater th an 240 mg/dl. Following 2-4 weeks of placebo administration the patien ts were randomly treated with one of the two drugs. When required dose s were increased and hydrochlorothiazide added until blood pressure lo wer than 160/95 mmHg was achieved. After this period the patients were observed for a minimum of 8 weeks. The mean length of the study was o f 22 weeks. RESULTS: Both drugs significantly reduced blood pressure w ithout modifying cardiac frequency. Doxazosin tended to favorably modi fy the lipid profile of the plasma while enalapril significantly reduc ed the levels of cholesterol, lipids and high density lipoproteins (HD L). Upon termination of the study the total HDL/cholesterol index incr eased 8.6 % in those treated with doxazosin and decreased 5.5 % in tho se receiving enalapril (p < 0.05). CONCLUSIONs: Although doxazosin and enalapril are potent antihypertensive drugs, the effects on plasma li pid obtained with doxazosin indicate that a reduction in cardiovascula r risk was achieved with this drug in the patients included in this st udy.