LONG-TERM TREATMENT WITH THE ACE-INHIBITOR CAPTOPRIL, ALONE OR IN COMBINATION WITH HYDROCHLOROTHIAZIDE, IN ELDERLY HYPERTENSIVES - EFFECTS ON BLOOD-PRESSURE AND QUALITY-OF-LIFE

The efficacy and tolerability of long-term treatment with the angioten sin converting enzyme inhibitor captopril was evaluated in elderly hyp ertensive subjects. One hundred thirty patients were studied (61 men a nd 69 women; mean age, 68.33 +/- 5.49 years), all with mild to moderat e arterial hypertension (mild = 90-105 mmHg; moderate = 105-115 mmHg). Patients with secondary hypertension were excluded from the study. Af ter a 2-week drug washout, patients were given captopril 25 to 100 mg/ day alone or in combination with hydrochlorothiazide (HCTZ) 25 mg/day for 15 weeks. After 2 weeks of treatment, significant decreases in sys tolic and diastolic blood pressures were observed (P < 0.001). Reducti ons in blood pressure persisted throughout the trial with final readin gs significantly lower than those at study start (baseline values, 182 .35 +/- 15.42/101.92 +/- 8.27 mmHg; final values, 146.41 +/- 11.22/84. 88 +/- 5.46 mmHg). Blood pressure was controlled by captopril in only 50.73% of patients, and combination therapy with HCTZ was warranted in 35.38%. The mean dose of captopril was 68 +/- 11 mg/day. At the end o f the study no variations in electrocardiographic or laboratory parame ters were seen in the population studied, and patients' quality of lif e, as assessed by means of a questionnaire, was found to be improved. Only five patients withdrew from the trial because of onset of side ef fects. Our results confirm the usefulness of captopril in the long-ter m treatment of arterial hypertension in the elderly, since its blood-p ressure-lowering effects are accompanied by improvements in the qualit y of life with no significant side effects. The combination of captopr il and HCTZ allows for better control of hypertension in larger number s of patients.