Aldactazine/captopril combination, safe and effective in mild to moderate systemic hypertension: report on a multicenter study of 967 patients

The safety and efficacy of a thiazide/potassium-sparing diuretic and an angiotensin-converting enzyme inhibitor used concomitantly was evaluated in a large, multicenter study. Aldactazine[TM] was administered alone for 2 months, after which time captopril was added in those whose blood pressure had not normalized (332 patients). At the end of the 6-month study, control of blood pressure was achieved in 88% of the patients with one or the other regimen. No clinically significant changes were recorded for a number of biologic parameters. Specifically, there was 1 case of hyperkalemia (6 mmol/liter), a very low incidence of hypotension (1.6%), and a low rate of adverse effects. Therefore, such a combination could provide important therapeutic benefits in hypertensive patients. (Am J Cardiol 1990;65:4K-6K)
Diuretics, such as thiazides, are agents that increase the excretion of water and are used to treat hypertension or high blood pressure. However, these antihypertensive agents may also cause decreased levels of potassium and magnesium, and lead to the development of arrhythmias or abnormal heart rhythms. Aldactazine is a combination of the potassium-retaining agent spironolactone and the thiazide diuretic, altizide, and was shown to reduce blood pressure without causing losses in potassium and magnesium. Another antihypertensive agent, captopril, prevents the formation of angiotensin, which constricts blood vessels and increases the secretion of the adrenal hormone aldosterone. This hormone increases the retention of sodium and the loss of potassium. Captopril is effective in treating mild hypertension, while maintaining or increasing potassium levels. However, if aldactazine and captopril were combined to treat hypertension, they may cause hyperkalemia or abnormally high levels of potassium, impaired kidney function, and hypotension (an abnormal drop in blood pressure). The effectiveness and safety of the combined drug regimen of aldactazine and captopril were assessed over a six-month period in 967 patients with hypertension. Aldactazine was given alone for the first two months and captopril was added only to the therapeutic regimen of 332 patients, whose blood pressures had not recovered to normal levels. At the end of the study, 88 percent of patients had well-controlled blood pressure with either drug regimen. There was one case of hyperkalemia, a very low incidence of hypertension, and few adverse drug effects. The results show that the combined regimen of aldactazine and captopril is both effective and safe in treating patients with hypertension. (Consumer Summary produced by Reliance Medical Information, Inc.)