A comparison of the efficacy of cilazapril versus cilazapril plus hydrochlorothiazide in patients with mild to moderate essential hypertension

Abstract

The efficacy of cilazapril monotherapy and in combination with hydrochlorothiazide 12.5 mg was compared in a multicentre, double blind, randomised parallel group study in 87 patients with mild to moderate essential hypertension over 8 weeks. After a 2 week single blind placebo run-in period, patients received either 2.5 mg cilazapril or 2.5 mg cilazapril plus 12.5 mg hydrochlorothiazide once daily. At Week 4 the cilazapril dose was increased from 2.5 mg to 5.0 mg if the mean sitting diastolic blood pressure was greater than 90 mmHg or had not decreased by more than 10 mmHg. After 8 weeks treatment 72% of patients responded to 2.5 mg cilazapril increasing to 88% with cilazapril 5.0 mg. For cilazapril plus hydrochlorothiazide, 83% responded to 2.5 mg cilazapril increasing to 96% on 5.0 mg cilazapril. The high response rate to low dose cilazapril monotherapy and hydrochlorothiazide combination therapy has important implications for minimising the cost of therapy with ACE inhibitors.

High percentage of responders to acei as a significant success factor in the treatment of hypertension

“…Po potrebi je titrirana doza oba leka na dva puta višu dozu, od 5 mg cilazaprila ili 50 mg kaptoprila, ili je dodat hidrohlorotiazid. Ukupan procenat respondera posle 8 nedelja je bio 47,1% za cilazapril u odnosu na 34% za kaptopril bez statistički značajne razlike 18 . Nakon 8 nedelja primene cilazaprila u studiji Kellaway i saradnika potvrđen je odličan procenat respondera od 72% pacijenata na dozi od 2.5 mg cilazaprila, sa poboljšanjem na 88% posle povećanja doze na 5 mg. Fiksna doza cilazaprila sa hidrohlorotiazidom je dodatno poboljšala procenat respondera na 83% i 96% za kombinaciju sa 2,5 i 5 mg cilazaprila 19 .…”