Advertisement

Captopril in elderly hypertensive patients

Results from a Multicenter Italian Trial
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      In this study, 953 patients (48 percent men) more than 60 years old with mild to moderate hypertension (class I or II) were included. After a two-week wash-out period, a starting dosage of captopril—12.5 mg twice a day—was given. Patients were examined after one and three weeks and, subsequently, at monthly intervals for a total period of four months. The dosage was adjusted to a maximum of 50 mg twice a day plus, when needed, 25 mg of hydrochlorothiazide per day. Thirty-two patients were lost to follow-up, 10 withdrew because of inadequate control of blood pressure, and only 21 (2 percent) dropped out because of side effects. Mean blood pressure decreased from 184/104 to 152/87 mm Hg. The lowest dosage (25 mg a day) was sufficient to control blood pressure in 15 percent of patients, 31 percent needed 50 mg a day, and 24 percent required 100 mg a day. Hydrochlorothiazide was added to the captopril regimen in 30 percent. No substantial changes in biochemical variables or electrocardiographic results were observed. “Quality of life” (judged as physical fitness, positive well being, mood, and sexual desire) remarkably improved.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Hodsman GP
        • Robertson JIS
        Captopril: five years on.
        Br Med J. 1983; 287: 851-852
        • Vestal RE
        Drug use in the elderly: a review of problems and special considerations.
        Drugs. 1978; 16: 358-382
        • Drayer J
        • Weber M
        Monotherapy of essential hypertension with a converting enzyme inhibitor.
        Hypertension. 1983; 5: 108-113
        • Veterans Administration Cooperative Study Group on Antihypertensive Agents
        Captopril: evaluation of low doses, twice daily doses, and the addition of diuretic for the treatment of mild to moderate hypertension.
        Clin Sci. 1982; 63: 443S-445S
        • European Working Party on High Blood Pressure in the Elderly
        Mortality and morbidity results.
        Lancet. 1985; I: 149-154
        • Johnson BF
        • Saunders R
        • Hickler R
        • et al.
        The effect of thiazide diuretics upon plasma lipoproteins.
        J Hypertens. 1986; 4: 235-239
        • Atkinson AB
        • Cunning AMM
        • Brown JJ
        • et al.
        Captopril treatment: inter-dose variations in renin, angiotensin I and II, aldosterone and blood pressure.
        Br J Clin Pharmacol. 1982; 13: 855-858
        • Aronow WS
        • Starling L
        • Etienne F
        • et al.
        Risk factors for coronary artery disease in persons older than 62 years in a long-term health care facility.
        Am J Cardiol. 1986; 57: 518-520
        • Rowe JW
        • Andres R
        • Robin JD
        • et al.
        The effect of age on creatinine clearance in man: a cross-sectional and longitudinal study.
        J Gerontol. 1976; 31: 155-163
        • Hollenberg NK
        Renal hemodynamics in essential hypertension.
        in: Influence of captopril. Am J Med. 76. 1984: 22-27
        • Smith A
        Qualms about QALYs.
        Lancet. 1987; I: 1134-1136
        • Croog SH
        • Levine S
        • Testa MA
        • et al.
        The effects of antihypertensive therapy on the quality of life.
        N Engl J Med. 1986; 314: 1657-1664