Evaluation of the effects of fixed combinations of sustained-release verapamil/trandolapril versus captopril/hydrochlorothiazide on metabolic and electrolyte parameters in patients with essential hypertension

The objective of this randomised open, active controlled, cross-over study was to evaluate the effect of a fixed combination of verapamil SR/trandolap ril compared to captopril/hydrochlorothiazide on serum lipids, lipoproteins , and other metabolic and electrolyte parameters in patients with essential hypertension. Another objective was to assess the efficacy and safety of b oth combinations. One hundred hypertensives with systolic blood pressure 14 0-209 mm Hg and diastolic blood pressure 90-119 mm Hg were evaluated after 16 weeks receiving a fixed combination of verapamil SR 180 mg/trandolapril 2 mg (VT) or captopril 50 mg/hydrochlorothiazide 25 mg (CH) both given once daily. Lipids and lipoproteins were assessed in duplicate on 2 consecutive days. The study was completed by 80 patients. There was no statistically s ignificant difference between the two combined regimens with respect to low -density lipoprotein (LDL)-cholesterol for the 'intention-to-treat' populat ion measured at the end of each treatment period (3.44 +/- 0.87 mmol/L with VT, and 3.46 +/- 0.86 mmol/L with CH). No differences were found for other lipid parameters like total cholesterol, triglycerides, apolipoproteins A1 and B, Lp(a). High-density lipoprotein (HDL)-cholesterol was significantly higher with VT (1.39 +/- 0.01 vs 1.35 +/- 0.01, P < 0.03). Serum potassium declined while uric acid and glucose increased on CH. In conclusion, no si gnificant differences were found in LDL-cholesterol and in other lipid para meters with the exception of HDL-cholesterol which was significantly higher on VT. Serum potassium declined while uric acid and glucose increased on C H (all significantly). Both fixed combinations were well tolerated. The inc idence of adverse events was higher on CH. Both fixed combinations signific antly lowered BP.