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Single Administration of Captopril and Combined Use with Beta-Blocker and/or Thiazide Diuretic in the Treatment of Essential Hypertension

Third Department of Internal Medicine, Nagoya City University Medical School

Toshio Kako

Department of Internal Medicine, Daiyukai General Hospital, Japan

Masaaki Koketsu

Third Department of Internal Medicine, Nagoya City University Medical School

Junichiro Hayano

Third Department of Internal Medicine, Nagoya City University Medical School

Takeshi Asakawa

Third Department of Internal Medicine, Nagoya City University Medical School

Takao Fujinami

Third Department of Internal Medicine, Nagoya City University Medical School

Tadashi Kato

Department of Anesthesiology, Toyokawa City Hospital, Aichi, Japan

Thirty-four patients with essential hypertension at WHO stage I or II were divided into three groups. Group I consisted of 22 cases who displayed normal renin activity (NR) or low renin activity (LR) and who received a single adminis tration of captopril. Group II consisted of 6 cases given beta-blockers after ad ministration of captopril. Group III consisted of 6 cases in whom beta-blocker was replaced with thiazide diuretics after administration of captopril alone. Blood pressure decreased significantly by captopril treatment alone in group I of the NR and LR subgroups (except for the diastolic blood pressure [DBP] of the NR subgroup) and fell below the target blood pressure (SBP of 165 mmHg and DBP of 95 mmHg) in 86% of the NR subgroup and 73% of the LR subgroup. Com bined treatment with captopril and beta-blocker in Group II did not decrease blood pressure any lower than with captopril alone treatment and achieved the target blood pressure in only 50% of the patients. In group III, combined treat ment with catopril and thiazide achieved the target blood pressure in 100% of the patients. Plasma renin activity (PRA) was increased by captopril but reduced by captopril in combination with beta-blocker. However, when beta-blocker was replaced with thiazide, PRA increased. The serum sodium concentration was significantly reduced in the LR subgroup after a single administration of cap topril, but there was no other variation.

Angiology, Vol. 42, No. 11, 914-923 (1991)
DOI: 10.1177/000331979104201107


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