Ferguson R K, Vlasses P H, Irvin J D, Swanson B N, Lee R B
J Clin Pharmacol. 1982 Jul;22(7):281-9. doi: 10.1002/j.1552-4604.1982.tb02676.x.
Eight patients with essential hypertension completed a double-blind, randomly allocated crossover comparison of either 5 or 10 mg enalapril maleate, 50 mg hydrochlorothiazide, or their combination administered once daily during sequential two-week periods. Blood pressure, pulse rate, plasma renin activity, angiotensin-converting enzyme activity, plasma aldosterone concentration, and urinary electrolytes were monitored for 24 hours after placebo and on days 1 and 14 of each treatment period. After two weeks of each treatment, only the combination of enalapril and hydrochlorothiazide significantly lowered the mean seated diastolic blood pressure (SDBP). Likewise, SDBP control (less than or equal to 90 mm Hg) was achieved only after combination therapy; six of the eight patients were controlled by the combination for up to 24 hours. The initial SDBP response to combination therapy differed with the sequence of drug addition; however, by day 14 the responses were comparable, regardless of whether hydrochlorothiazide or enalapril was first given. Mean converting enzyme activity was suppressed by enalapril in all patients, though it did not always correlate with changes in SDBP or plasma aldosterone. Mean plasma renin activity increased, but the increase was significant only on the combination. There were no serious adverse effects.
八名原发性高血压患者完成了一项双盲、随机分配的交叉对照试验，在连续两周的时间里，每天服用一次5毫克或10毫克马来酸依那普利、50毫克氢氯噻嗪或它们的组合。在服用安慰剂后以及每个治疗期的第1天和第14天，对血压、脉搏率、血浆肾素活性、血管紧张素转换酶活性、血浆醛固酮浓度和尿电解质进行24小时监测。每个治疗两周后，只有依那普利和氢氯噻嗪的组合显著降低了平均坐位舒张压（SDBP）。同样，只有联合治疗后才能实现SDBP控制（小于或等于90毫米汞柱）；八名患者中有六名通过联合治疗可维持24小时血压控制。联合治疗开始时SDBP的反应因加药顺序而异；然而，到第14天，无论先给予氢氯噻嗪还是依那普利，反应都是相当的。所有患者的依那普利均抑制了平均转换酶活性，尽管它并不总是与SDBP或血浆醛固酮的变化相关。平均血浆肾素活性增加，但仅在联合治疗时增加显著。未出现严重不良反应。
