Captopril/hydrochlorothiazide combination in elderly patients with mild-moderate hypertension. A double-blind, randomized, placebo-controlled study.

Fifty-six elderly patients (mean age 72.1 +/- 4.1 years; mean creatinine 111.0 +/- 9.8 mumol/l were randomly assigned to either captopril (C) hydrochlorothiazide (HCT) fixed combination once daily (o.d.) (n = 29) or placebo (n = 27). Previous medication was stopped and following a run-in period of 2 weeks on placebo, the initial dosage was C (25 mg)/HCT (12.5 mg) o.d.; after 6 weeks it was increased to C (50 mg)/HCT (25 mg) o.d. for all the treated subjects; these doses were maintained for an additional 6 weeks. Blood pressure, heart rate, body weight and side effects were assessed every 2 weeks. After the run-in period as well as after the two treatment periods, routine biochemical examinations were carried out on all patients. Twenty to 24 hours after the last intake both C 25/HCT 12.5 o.d. and C 50/HCT 25 o.d. had significantly lowered blood pressure compared with placebo (P less than 0.001). The percentages of normalized patients (supine diastolic less than or equal to 90 mm Hg) were 3.7% (placebo), 72.4% (C25/HCT 12.5) after 6 weeks and 7.7% (placebo) and 96.6% (C 50/HCT 25) after 12 weeks. No important side effect was reported on captopril/hydrochlorothiazide combination. Haematological and biochemical changes were within the normal range in both groups. We conclude that a once daily captopril/hydrochlorothiazide combination is effective and safe in elderly patients with mild to moderate hypertension.