EFFECTS OF BENAZEPRIL ALONE AND IN COMBINATION WITH HYDROCHLOROTHIAZIDE IN COMPARISON WITH FELODIPINE EXTENDED-RELEASE IN ELDERLY PATIENTS WITH MILD-TO-MODERATE ESSENTIAL-HYPERTENSION

The sim of this study was to assess the efficacy and tolerability of t wo antihypertensive regimens-one using benazepril, eventually combined with hydrochlorothiazide in nonresponders, and the other using titrat ion of felodipine extended release (ER)-in elderly patients with hyper tension. After a 2-week washout period, 236 patients (127 men and 109 women aged 65 to 80 years) with mild-to-moderate essential hypertensio n (systolic blood pressure [SBP] greater than or equal to 160 mm Hg an d diastolic blood pressure [DBP] greater than or equal to 95 mm Hg), w ere given benazepril 10 mg once daily (n = 118) or felodipine ER 5 mg once daily (n = 118) for 4 weeks, according to a multicenter, randomiz ed, double-masked design. At the end of this treatment period, patient s responding to treatment were kept at the same dose of their respecti ve randomized drug for an additional 8 weeks. The nonresponders were g iven the fixed combination benazepril 10 mg plus hydrochlorothiazide 1 2.5 mg or felodipine ER 10 mg. Patients were examined at the end of th e washout period and every 4 weeks thereafter. At each visit, sitting SEP and DBP were measured with a mercury sphygmomanometer and heart ra te by radial pulse palpation. Adverse events were recorded. Both benaz epril and felodipine ER were similarly effective in reducing SBP and D BP. No significant differences between the two treatment groups were o bserved in the mean decreases in blood pressure or in the number or pe rcentage of patients with successful responses to treatment. Both trea tments were well tolerated; the incidence of drug-related side effects , however, was slightly but significantly higher in the felodipine ER- treated group than in the benazepril group (14.4% vs 8.5%). In conclus ion, benazepril 10 mg given as monotherapy, or as a fixed combination with hydrochlorothiazide in nonresponders, and felodipine ER 5 mg, tit rated to 10 mg in nonresponders, were both effective and well tolerate d in elderly patients with hypertension.