Rappelli A
Istituto di Patologia Medica, Universita degli Studi, Ancona, Italy.
J Hum Hypertens. 1991 Dec;5 Suppl 2:55-7; discussion 57-8.
The efficacy and tolerability of a combination of lisinopril 20 mg and hydrochlorothiazide 12.5 mg once daily (L/HCTZ) was compared with a combination of captopril 50 mg and hydrochlorothiazide 25 mg once daily (C/HCTZ) in a multicentre, open, randomized, parallel-group study involving mild to moderate hypertensive patients. A total of 87 patients were randomized to lisinopril and 87 to captopril. Six weeks of treatment with lisinopril or captopril lowered supine BP by 13.3/8.8 mm Hg and 8.7/6.5 mm Hg, respectively. After 4 weeks of combination treatment, BP 24 hours post dose fell to 144.0 +/- 1.3/88.1 +/- 0.7 mm Hg in the L/HCTZ group vs 146.8 +/- 1.3/90.3 +/- 0.7 mm Hg in the C/HCTZ group (P less than 0.05 DBP; differences in SBP were not significant, ns). The proportion of patients normalized (DBP less than or equal to 90 mm Hg) was 79.5% vs 72% for L/HCTZ and C/HCTZ, respectively (ns). A total of 93.6% of patients on L/HCTZ achieved a fall in DBP of greater than or equal to 10 mm Hg, compared with 86.7% of patients on C/HCTZ (ns). One patient on lisinopril withdrew because of coughing. No statistically significant differences were observed between L/HCTZ and C/HCTZ with regard to adverse events. In conclusion, L/HCTZ was as well tolerated as C/HCTZ, but produced a greater fall in DBP.
在一项涉及轻至中度高血压患者的多中心、开放、随机、平行组研究中，比较了每日一次服用20毫克赖诺普利和12.5毫克氢氯噻嗪（L/HCTZ）的联合用药与每日一次服用50毫克卡托普利和25毫克氢氯噻嗪（C/HCTZ）的联合用药的疗效和耐受性。共有87例患者被随机分配至赖诺普利组，87例患者被随机分配至卡托普利组。用赖诺普利或卡托普利治疗6周后，仰卧位血压分别降低了13.3/8.8毫米汞柱和8.7/6.5毫米汞柱。联合治疗4周后，L/HCTZ组给药后24小时血压降至144.0±1.3/88.1±0.7毫米汞柱，而C/HCTZ组为146.8±1.3/90.3±0.7毫米汞柱（舒张压P<0.05；收缩压差异不显著，无统计学意义）。L/HCTZ组和C/HCTZ组血压正常（舒张压≤90毫米汞柱）的患者比例分别为79.5%和72%（无统计学意义）。L/HCTZ组共有93.6%的患者舒张压下降≥10毫米汞柱，而C/HCTZ组为86.7%（无统计学意义）。1例服用赖诺普利的患者因咳嗽退出。在不良事件方面，L/HCTZ和C/HCTZ之间未观察到统计学上的显著差异。总之，L/HCTZ的耐受性与C/HCTZ相当，但能使舒张压有更大幅度的下降。
