Enalapril versus hydrochlorothiazide: DISCUSSION(1) / Symbicort Price

20 Sep
2012

The overall incidence of clinical adverse experiences are reported in Table 5. Of the 20 adverse experiences reported by 14 patients receiving enalapril, only two events (definitely not related to therapy) were noted as serious (chest pain and dissecting aortic aneurysm) in one patient who discontinued the drug. For the 24 events reported in 18 patients who received hctz/ amiloride, three events (probably not related to therapy) were rated as serious (atrial fibrillation, dizziness and he-mate me sis) in one pa tient who also discon tin ued the drug. One adverse experience was reported as an urticarial eruption definitely associated with enalapril. Although it was classified as mild, the patient discontinued the drug and recovered without sequelae. One patient receiving hctz/ amiloride experienced an episode of gout that was considered to be possibly related to the study drug.

TABLE 5

Clinical adverse effects comparison

EnalaprilHCTZ/amilorideTotal
Adverse effects present (patients)14 (15.6%)18 (19.6%)32 (17.6%)
Adverse effects absent (patients)76 (84.4%)74 (80.4%)150 (82.4%)
Total patients9092182
Total adverse effect events202444
Total laboratory events201636
Total patients with laboratory events131023

HCTZ Hydrochlorothiazide.

DISCUSSION

The results of this multicentre study demonstrate that the ace inhibitor, enalapril, and the potassium-sparing diuretic, hctz/ amiloride, are both efficacious in the treatment of mild to moderate hypertension after 12 to 16 weeks oftreatment. In both treatment groups, over 80% of pat ients achieved adequate blood pressure control, which is in high agreement with ear lier reports.

Patients receiving hctz/ amiloride tended to have a greater mean reduction in their systolic and diastolic blood pressure in the supine and standing position after 1 and 3 mins versus those receiving enalapril, at study exit. This resulted in a statistically significant mean difference between the treatments for systolic blood pressure. This outcome demonstrates the efficacy of diuretics in treating mild to moderate forms of hypertension as a first-line agent. You can soon shop with a nice pharmacy offering Symbicort Price to benefit more.

There are several possible explanations to account for this difference in favour of hctz/ amiloride. One may reason that the greater efficacy demonstrated in the hctz/ amiloride group may have been due to a greater number of patients in this group receiving higher dosages but this was, in fact, not the case. Patients who received hctz/ amiloride were slightly older than those who received enalapril and it has been shown that older patients respond better to diuretics. The age difference between group s in the present study, however, was not statistically significant. Thus, the hctz/ amiloride combination doses used in the present study appear to be slightly more potent than enalapril alone when acting on systolic blood pressure when patients are standing.

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