Combined captopril treatment in severe and moderately severe hypertension resistant to therapy.

Combined Captopril treatment was applied in 61 patients with severe or moderately severe hypertension in patients insufficiently or not reacting to the usual combined antihypertensive therapy (3-7 kinds of drug). The combination included diuretics, beta-blockers, alpha-blockers, vasodilators, Ca-antagonists and centrally acting agents. Diuretics were used in all cases. Average duration of treatment was 8.2 months (i.e. 2-40 months). Mean systolic pressure prior to Captopril treatment was 202.4 mm Hg (S.D. +/- 27.6), while the diastolic 122.0 mm Hg (S.D. +/- 11.3). During combined Captopril treatment the average values were 154.2 mm Hg (S.D. +/- 18.8) and 97.6 mm Hg diastolic pressures (S.D. +/- 10.7), the difference being significant (p less than 0.001). Refractory hypertension occurred in three middle-aged female patients in response to combined Captopril treatments. Captopril treatment had to be discontinued for the appearance of side-effects (severe skin symptoms) only in a single case. A minor deterioration of renal functions was observed in three patients (in one bilateral renovascular, and in two essential hypertension). Serum creatinine value and renal functions of four patients showed significant improvement as a result of combined Captopril treatment. During combined Captopril treatments (also with a diuretic) two patients had so severe hypokalaemia that they needed potassium substitution or administration of a potassium-saving diuretic.