A single-blind, randomized, cross-over study of angiotensin-converting enzyme inhibitor and triamterene and hydrochlorothiazide in the treatment of mild to moderate hypertension in the elderly.

Forty patients over 70 years old with a diastolic blood pressure of 95 to 110 mm Hg and/or a systolic blood pressure of 170 to 220 mm Hg after two weeks' placebo therapy underwent a single-blind, placebo-controlled, randomized cross-over study using captopril and triamterene and hydrochlorothiazide (Dyazide). Blood pressure was lowered from a mean of 189 +/- 2.0/92 +/- 1.7 mm Hg (mean +/- SEM) to 161 +/- 2.8/78 +/- 1.7 mm Hg with captopril therapy, and therapy with triamterene and hydrochlorothiazide produced similar reductions (156 +/- 2.7/78 +/- 1.7 mm Hg). Two patients on triamterene and hydrochlorothiazide therapy withdrew because of side effects, while only minor side effects were observed with captopril therapy. Therapy with triamterene and hydrochlorothiazide produced significant elevation of urea, creatinine, and uric acid, while captopril therapy produced no biochemical or hematologic changes. A single daily dose of captopril alone was sufficient to normalize the blood pressure in 31 (75%) of 40 patients. Captopril appears to be a promising monotherapy for the elderly with mild to moderate hypertension.