A randomised double blind comparison of enalapril versus hydrochlorothiazide in elderly hypertensives. 1989

S Grosskopf, and R German, and L J Beilin, and R Vandongen, and P Rogers
University Department of Medicine, Royal Perth Hospital, Western Australia.

To assess the suitability of therapy with an angiotensin-converting enzyme inhibitor for older hypertensives, a randomised double blind two group comparison of enalapril (10 to 40 mg daily) with hydrochlorothiazide (25 to 100 mg daily) was carried out in 32 untreated and independently living subjects aged 63 to 82 years with pressures on screening greater than 100 mmHg diastolic or greater than 180 mmHg systolic and after two weeks on placebo greater than 90 mmHg diastolic or greater than 160 mmHg systolic. Twenty-five subjects completed the ten weeks of active treatment with the majority in both groups reaching target blood pressures. Four subjects on enalapril and three on hydrochlorothiazide withdrew because of side effects. Eighteen of the 32 patients volunteered troublesome symptoms they attributed to therapy, which in some instances were alleviated by reductions in drug dosage. Small but significant falls in plasma potassium and sodium and increases in plasma urea and uric acid were seen on hydrochlorothiazide only. It was concluded that although in most cases good blood pressure control can be achieved by enalapril with some advantages over other drugs in the elderly, the potential for adverse effects remains significant. Halving usual starting doses of this and other antihypertensives may help to minimise problems in older subjects.

UI MeSH Term Description Entries
D006973 Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010352 Patient Dropouts Discontinuance of care received by patient(s) due to reasons other than full recovery from the disease. Dropout, Patient,Dropouts, Patient,Patient Dropout
D011897 Random Allocation A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. Randomization,Allocation, Random
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D004656 Enalapril An angiotensin-converting enzyme inhibitor that is used to treat HYPERTENSION and HEART FAILURE. Enalapril Maleate,MK-421,MK421,Renitec,Renitek,MK 421,Maleate, Enalapril
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006852 Hydrochlorothiazide A thiazide diuretic often considered the prototypical member of this class. It reduces the reabsorption of electrolytes from the renal tubules. This results in increased excretion of water and electrolytes, including sodium, potassium, chloride, and magnesium. It is used in the treatment of several disorders including edema, hypertension, diabetes insipidus, and hypoparathyroidism. Dichlothiazide,Dihydrochlorothiazide,Esidrex,Esidrix,HCTZ,HydroDIURIL,Hypothiazide,Oretic,Sectrazide
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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