Microzide
[Evaluation of efficacy of the enalapril-hydrochlorothiazide combination by ambulatory blood pressure monitoring in essential hypertensive patients]

[Article in Portuguese]

Oigman W, Spritzer N, Introcaso L, Santello JL.

Universidade do Estado do RJ.

PURPOSE--Evaluation the 24 hours efficacy of once daily enalapril plus hydrochlorothiazide association by ambulatory blood pressure monitoring. METHODS--Thirty-nine essential hypertensive patients (3 male, 36 female; 31 white, 8 non-white; mean age 46,7 years old) with the criteria, after wash-out period, of more than 40% of diurnal diastolic blood pressure measurements above 90mmHg by ambulatory blood pressure monitoring, were allocated for treatment during 8 weeks with once daily administration of enalapril (20mg) plus hydrochlorothiazide (12.5mg) association. RESULTS--After wash-out period, 82 and 42%, respectively, diurnal and nocturnal systolic blood pressure measurements were above 140mmHG; while diastolic values were 79 and 26% above 90mmHg. After 8 weeks of treatment there was a significant reduction in both systolic and diastolic pressure loads, either on nocturnal or diurnal periods; 26 and 5.3% of systolic values were still above 140mmHg and, 31.5 and 7.9% of diastolic measurements were above 90mmHg. Despite the significant fall on blood pressure there was not alteration in heart rate. CONCLUSION--The association of the angiotensin converting enzyme inhibitor, enalapril, plus a diuretic, hydrochlorothiazide, promoted a significant reduction on pressure load and did not interfere with the circadian rhythm of 24 hours blood pressure. These results may indicate that the association as suitable as one of the first choices for treating mild and moderate hypertensive patients.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8240048&dopt=Abstract hydrochlorothiazide Microzide



Microzide
[Treatment of mild hypertension with captopril and captopril with hydrochlorothiazide. Impact on blood pressure values and quality of life]

[Article in Spanish]

Escobar E, Roessler E, Zarate H, Roman O, Valdes G, Medina E.

Departamento de Medicina, Hospital del Salvador, Facultad de Medicina Universidad de Chile, Santiago de Chile.

The effects of captopril alone or associated to hydrochlorothiazide on blood pressure and quality of life was studied in 244 hypertensive subjects. After a medication wash out period of 30 days (and 7 additional days when diuretics were used) patients were treated initially with captopril 25 mg b.i.d. (scheme A); if blood pressure was not normalized, hydrochlorothiazide 25 mg o.d. was added (scheme B) and the dose of captopril was increased to 50 mg bid (scheme C) in a stepwise fashion. Sixteen patients (6.6%) were lost from follow up; in the rest a significant reduction of blood pressure was obtained at the end of the treatment period (from 163/98.9 +/- 19.7/3.1 to 143/85 +/- 12.7/6.7 p < 0.05), without changes in cardiac frequency. Using captopril alone, blood pressure was normalized at 15 and 75 days in 62.9 and 70.6% of patients respectively. With captopril plus hydrochlorothiazide blood pressure was normalized in 80.9% of patients. Quality of life improved significantly from of 42.8 +/- 1.7 to 50.7 +/- 15 score points (p < 0.05) secondary effects were observed in 7.4% of patients. It is concluded that captopril alone or associated to hydrochlorothiazide is effective in the treatment of mild hypertension, produces few secondary effects and improves the quality of life.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8248636&dopt=Abstract hydrochlorothiazide Microzide



Microzide
Captopril and hydrochlorothiazide (Capozide) combine to enhance the reduction in voluntary alcohol intake in rats.

Robertson JM, Harding S, Grupp LA.

Primary Mechanisms Department, Addiction Research Foundation of Ontario, Toronto, Canada.

The effect of Capozide, the combination of captopril with a hydrochlorothiazide diuretic, on voluntary alcohol intake was assessed in two experiments. In experiment 1 naive rats who were maintained on ad libitum food and water were given daily 40-min access to a 6% (w/v) alcohol solution and water. Daily intraperitoneal injections of captopril (10 mg/kg) reduced alcohol intake, but the combination of captopril (5 and 10 mg/kg) and hydrochlorothiazide (2.5, 5, and 10 mg/kg) enhanced the reduction in intake. In experiment 2, captopril alone, hydrochlorothiazide alone, and the combination of captopril and hydrochlorothiazide were again administered daily in the limited access procedure. Captopril (10 mg/kg) again reduced alcohol intake as did all three doses of hydrochlorothiazide (2.5, 5, and 10 mg/kg). Compared with the individual effects of captopril and hydrochlorothiazide, Capozide exerted a supra-additive reduction in alcohol intake. These effects were not due to drug-induced changes in the pharmacokinetics of alcohol. Taken together these results demonstrate an enhanced potency of Capozide in suppressing alcohol intake and invite their testing in a population of hypertensive alcoholics and alcohol abusers.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8279680&dopt=Abstract hydrochlorothiazide Microzide



Microzide
Efficacy and tolerability of a combination of enalapril and hydrochlorothiazide in the treatment of hypertension measured manually and with an ambulatory blood pressure monitor.

Weir MR, Lavin PT, Byrnes CA.

Department of Medicine, University of Maryland, Baltimore.

The efficacy and tolerability of an enalapril maleate-hydrochlorothiazide combination (EM-HCTZ) were evaluated in a prospective, open-label study in 26 patients with uncomplicated essential hypertension (mean baseline sitting systolic/diastolic blood pressure: 153/103 mmHg) requiring two agents to reduce sitting diastolic blood pressure (SDBP) below 90 mmHg. Their mean age was 52 years. Patients received enalapril 5 mg daily, which was increased to 10 mg if SDBP was not reduced to < 90 mmHg during a 5-week titration period following washout. If blood pressure did not reach that goal, 25 mg hydrochlorothiazide was added. Only patients who required enalapril 10 mg and hydrochlorothiazide 25 mg for control (SDBP < 90 mmHg) at the end of titration received open-label EM-HCTZ as maintenance therapy for 6 weeks. The SDBP of 19 of the 26 patients (73%) who began titration was controlled at the end of titration, and they received maintenance therapy. During maintenance, the mean SDBP decreased from baseline 13.2 mmHg at week 2, 13.3 mmHg at week 4, and 10.1 mmHg at week 6. All changes from baseline were significant. At the end of the maintenance period, SDBP was controlled in 8 (42%) of 19 patients enrolled. One patient was withdrawn from the study because blood pressure was poorly controlled. Ambulatory blood pressure (ABP) was monitored, average outcome was computed for each patient during the 24-hour interval, and with a paired comparison, baseline and follow-up data were compared with the data measured manually. The mean baseline ABP was 9 mmHg lower than the baseline SDBP measured manually (r = 0.58, P = 0.01). Following treatment with EM-HCTZ, mean diastolic blood pressure fell 10 mmHg and mean systolic blood pressure fell 15 mmHg. In summary, EM-HCTZ was highly effective and generally well-tolerated in a substantial proportion of participants whose SDBP remained > 90 mmHg on enalapril 10 mg. Important differences between blood pressure measured manually and with a monitor were also demonstrated.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8364944&dopt=Abstract hydrochlorothiazide Microzide



Microzide
[Idiopathic hypercalciuria--the effect of physical stress on calciuria]

[Article in Czech]

Kocian J.

Katedra interniho lekarstvi, ILF, Praha.

The authors investigated calciuria (dU-Ca) in a group of 37 patients with confirmed idiopathic hypercalciuria. The group comprised 17 men, mean age 46.1 +/- 10.4 years, and 20 women, mean age 55.7 +/- 14.9 years (on statistical evaluation the group of women was significantly older, p > 0.01). After a load the calciuria declined in men by 27.3%, in women by 31.3%, in the total group by 27.85% (all reduced values are statistically significant as compared with controls, p < 0.001). In individual subjects calciuria declined by as much as 58%. Similar results were achieved during treatment with hydrochlorothiazide: the drop of calciuria during a physical load in men was 27.60%, in women 34.70%. The group of patients who participated in the whole programme, i.e. rest/load and rest/load after one month hydrochlorothiazide treatment, 25 mg/day, is too small for conclusive evaluation. Conclusion: physical load and hydrochlorothiazide reduce the amount of calcium excreted in urine by patients with idiopathic hypercalciuria.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8458066&dopt=Abstract hydrochlorothiazide Microzide