COMPARISON OF THE COMBINATION OF ENALAPRIL AND A VERY-LOW DOSE OF HYDROCHLOROTHIAZIDE WITH ATENOLOL IN PATIENTS WITH MILD-TO-MODERATE HYPERTENSION

The blood pressure lowering effect and tolerability of the angiotensin -converting enzyme inhibitor enalapril combined with a very low dose o f hydrochlorothiazide (HCTZ) were compared with the selective betarece ptor blocker atenolol in patients with mild-to-moderate hypertension. Three hundred seventy-four patients were randomized into a triple-blin d, parallel, active-controlled 12-week study period comparing enalapri l/HCTZ (20/6 mg) with atenolol (50 mg) after a 4-week placebo baseline period. Blood pressure (BP), clinical and laboratory safety, and meta bolic laboratory variables were assessed. Enalapril/HCTZ as well as at enolol reduced both sitting and standing diastolic and systolic BP (P < . 001), but enalapril/HCTZ had a more pronounced effect than atenolo l on sitting systolic BP (P = . 019); there was a trend toward more pa tients achieving target diastolic BP (<90 mm Hg, P = .053). No clinica lly important differences in safety and tolerability were observed. (C ) 1997 American Journal of Hypertension, Ltd.