USEFULNESS OF PIRETANIDE PLUS RAMIPRIL FOR SYSTEMIC HYPERTENSION - A MULTICENTER TRIAL

To test the dose responses of piretanide, ramipril, and their combinat ion in patients with essential hypertension, a prospective, randomized , double-blind, placebo-controlled trial was conducted in 480 patients . Twelve separate groups were studied: placebo, piretanide 3 mg, piret anide 6 mg, ramipril 2.5 mg, ramipril 5 mg, ramipril 10 mg, and their combinations, as single daily morning doses. Patients were randomized after a 2-week run-in period without drugs; treatment was given for 6 weeks. A dose response compared with placebo was found for both drugs; the combination was more effective than either drug alone. Piretanide 6 mg, combined with ramipril 5 mg, provided optimal blood pressure re duction. Self-reported adverse effects of both drugs and their combina tions did not exceed those reported for placebo. A surface analysis su ggested that piretanide primarily reduced systolic blood pressure, whe reas ramipril was more effective in reducing diastolic blood pressure. The data attest to a combined efficacy of piretanide and ramipril in decreasing arterial blood pressure.