Long‐term experience of captopril in the treatment of primary (essential) hypertension.

Abstract

1 Forty‐one patients with primary (essential) hypertension were treated with captopril alone or in combination with hydrochlorothiazide for 12‐ 36 months. 2 During an initial dose‐titration period mean blood pressure fell from 174/111 mm Hg to 134/88 mm Hg supine and from 170/116 mm Hg to 126/93 mm Hg standing after 3 months' treatment. 3 During long‐term treatment with unchanged or reduced doses of captopril or hydrochlorothiazide, or both, blood pressure remained substantially reduced. Mean supine blood pressure at 24 months was 136/90 mm Hg and at 36 months 138/90 mm Hg. 4 In 12 patients with clearly defined low renin (essential) hypertension initial blood pressure reduction was less than in patients with normal renin hypertension after 1 month's treatment (162/102 mm Hg v 143/92 mm Hg). After 24 months of treatment, however, the treatment results were similar in the two groups. 5 Except for one case of reversible proteinuria no serious side effects were seen during treatment periods of up to three years. 6 Captopril alone or in combination with hydrochlorothiazide seems to be an effective and safe drug in the long‐term treatment of primary hypertension.

Control of Energy Balance by the Brain Renin-Angiotensin System

“…Interestingly, pharmacological inhibition of the RAS is beneficial for almost all forms of hypertension, including forms with low circulating RAS activity [21][22][23][24]. This observation is consistent with a role for RAS activity beyond its circulatory actions in the pathogenesis and maintenance of hypertension.…”

Effects of repeated doses of enalapril on renal function in man.

“…Weinberger (1982) reported that chronic captopril therapy (75 mg daily), in hypertensive patients, resulted in blunting of hyperuricaemic effects of concurrent hydrochlorothiazide therapy. Other long term experience with variable dosage of captopril (up to 450 mg daily) did not show these effects (Karlberg et al, 1982).…”