Lees K R, Reid J L, Scott M G, Hosie J, Herpin D, Santoni J P
University Department of Materia Medica, Stobhill General Hospital, Glasgow, UK.
J Hum Hypertens. 1989 Feb;3(1):17-22.
This was a double blind, parallel group, multicentre comparison of the therapeutic efficacy and acceptability of perindopril and captopril in essential hypertension. After one month of placebo, 165 patients with supine diastolic blood pressure (DBP) between 95 and 125 mmHg were randomised to perindopril 4 mg once daily or captopril 25 mg twice daily orally. The perindopril group (n = 82) had significantly higher pretreatment DBP (105.4 +/- 0.8 mmHg vs 102.3 +/- 0.6 mmHg) but other demographic variables were similar. Assessment was monthly for three months: 'uncontrolled' patients (DBP greater than 90 mmHg) had the dose doubled and then hydrochlorothiazide added. Two of the six withdrawals were attributed to drug side effects and were in the captopril group. There was no significant difference in the number of withdrawals or incidence of side effects between the drugs. The final titrated treatments were similar and monotherapy normalised DBP in 49% of each group. The final 'control' rate was higher with perindopril than captopril: 75% vs 57%, P = 0.016. The overall fall in DBP was greater in the perindopril group: 26.5 +/- 1.9 mmHg vs 18.9 +/- 1.9 mmHg, P = 0.005. The doses of diuretic were similar in the two groups. The DBP of patients who received only monotherapy for three months also fell more in the perindopril group (-17.5 +/- 1.4 mmHg vs -13.9 +/- 1.0 mmHg, P less than 0.01). At the doses studied, perindopril was more effective than captopril in lowering DBP, either as monotherapy or in combination with a diuretic.(ABSTRACT TRUNCATED AT 250 WORDS)
这是一项关于培哚普利和卡托普利治疗原发性高血压的疗效及耐受性的双盲、平行组、多中心比较研究。在服用一个月安慰剂后，165例仰卧位舒张压（DBP）在95至125 mmHg之间的患者被随机分为两组，一组每日口服一次培哚普利4 mg，另一组每日口服两次卡托普利25 mg。培哚普利组（n = 82）的治疗前DBP显著更高（105.4±0.8 mmHg对102.3±0.6 mmHg），但其他人口统计学变量相似。为期三个月，每月进行评估：“未控制”的患者（DBP大于90 mmHg）剂量加倍，然后加用氢氯噻嗪。6例退出研究的患者中有2例归因于药物副作用，均在卡托普利组。两组之间的退出人数或副作用发生率无显著差异。最终滴定治疗相似，每组中49%的患者单药治疗使DBP正常化。培哚普利的最终“控制”率高于卡托普利：75%对57%，P = 0.016。培哚普利组DBP的总体下降幅度更大：26.5±1.9 mmHg对18.9±1.9 mmHg，P = 0.005。两组利尿剂的剂量相似。仅接受三个月单药治疗的患者的DBP在培哚普利组中下降也更多（-17.5±1.4 mmHg对-13.9±1.0 mmHg，P＜0.01）。在所研究的剂量下，培哚普利在降低DBP方面比卡托普利更有效，无论是单药治疗还是与利尿剂联合使用。（摘要截选至250字）
