Treatmetn of mild to moderate hypertension with or without the converting enzyme inhibitor enalapril

摘要: A group of 205 patients with mild to moderate essential uncomplicated hypertension was chosen from 3,183 hypertensive referred a clinic for the first time, and asked participate in six-month double-blind parallel trial. single physician charge all patients. After two-week single-blind placebo period, were randomly assigned regimens either enalapril (20 mg per day) or placebo. Both groups then followed up every two weeks, increasing doses hydrochlorothiazide (25 50 mg), oxprenolol (160 320 dihydralazine (50 100 mg) added until diastolic blood pressure lower than 90 mm Hg. follow-up, showed systolic pressures control (129/82 +/- 12/6 Hg versus 135/86 10/5 Hg; p less 0.001). The number daily tablets active drugs 2.7 1.8 4.4 2.4 (p 0.01). mean plasma potassium level 4.16 0.4 mmol/liter 3.92 0.001), despite more frequent use amiloride This difference is explained by dose used comparison group, excretion urinary aldosterone (11.6 7.4 19.8 11.8 micrograms 24 hours, Drug withdrawal necessary eight 16 0.05). These results show that first-step treatment permits better standard treatment, requires fewer be taken daily, involves smaller risk hypokalemia.