Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The efficacy and tolerability of a combination of lisinopril 20 mg and hydrochlorothiazide 12.5 mg once daily (L/HCTZ) was compared with a combination of captopril 50 mg and hydrochlorothiazide 25 mg once daily (C/HCTZ) in a multicentre, open, randomized, parallel-group study involving mild to moderate hypertensive patients. A total of 87 patients were randomized to lisinopril and 87 to captopril. Six weeks of treatment with lisinopril or captopril lowered supine BP by 13.3/8.8 mm Hg and 8.7/6.5 mm Hg, respectively. After 4 weeks of combination treatment, BP 24 hours post dose fell to 144.0 +/- 1.3/88.1 +/- 0.7 mm Hg in the L/HCTZ group vs 146.8 +/- 1.3/90.3 +/- 0.7 mm Hg in the C/HCTZ group (P less than 0.05 DBP; differences in SBP were not significant, ns). The proportion of patients normalized (DBP less than or equal to 90 mm Hg) was 79.5% vs 72% for L/HCTZ and C/HCTZ, respectively (ns). A total of 93.6% of patients on L/HCTZ achieved a fall in DBP of greater than or equal to 10 mm Hg, compared with 86.7% of patients on C/HCTZ (ns). One patient on lisinopril withdrew because of coughing. No statistically significant differences were observed between L/HCTZ and C/HCTZ with regard to adverse events. In conclusion, L/HCTZ was as well tolerated as C/HCTZ, but produced a greater fall in DBP.
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PMID:Controlling hypertension: lisinopril-hydrochlorothiazide vs captopril-hydrochlorothiazide. An Italian multicentre study. 166 78

The effect of single dose (50 mg) Captopril (C) used either alone or associated to diuretics (50 mg hydrochlorothiazide -HCTI) in the treatment of mild-moderate essential arterial hypertension was studied in a multicentric study. Eighty eight patients were chosen. After a minimum of 4 month follow-up period 53.4% responded (BDP less than 95 mm Hg) to single dose C (group 1:47 patients), 89.77% to 50 mg C in single dose together with 50 mg HTIT (group 2: 32 patients), 95.45% of two 50 mg doses of C and 50 mg HCIT (group 3: 5 patients), and 97.72% responded to 3 doses of C and 50 mg of HCTI (group 4: 2 patients). The decrease in blood pressure values was statistically significant (p, 000, Wilcoxon test) in groups 1 and 2, having a mean decrease in blood pressure (BP) of 14%. In group 1 (n = 42) the SBP which initially was 165.72 +/- 11.32, decreased to 148.28 +/- 11.5 and the DBP decreased from 101.55 +/- 5.68 to 87.28 +/- 6.59. In group 2 (n = 32) the SBP decreased from 173.50 +/- 14.08 to 152.44 +/- 20.8 and the DBP from 103.34 +/- 5.29 to 87.47 +/- 6.39. The response to monotherapy could not be statistically correlated either to early essential hypertension or to the patients age. Treatment was discontinued in three cases due to the secondary effects, cough, ageusia and nervousness, showing the remaining patients a good tolerance. No changes were observed in the analytical parameters. This study shows the usefulness and tolerance of single dose C as the initial treatment of mild to moderate essential hypertension.
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PMID:[Captopril in single doses in the treatment mild-moderated arterial hypertension]. 219 35

The antihypertensive efficacy and acceptability of perindopril (P) were compared to those of captopril (C), atenolol (A) and a diuretic, hydrochlorothiazide + amiloride (D), in 3 double-blind parallel multicenter studies involving 165, 173, and 165 patients, respectively. Patients with essential hypertension and a supine DBP between 95 and 125 mmHg (mean 103.9, 106.2, and 105.2 mmHg, respectively) after a 1-month placebo period were randomized to P 4 mg once daily (o.d.) and either C 25 mg twice daily, or A 50 mg o.d. or D (hydrochlorothiazide 50 mg + amiloride 5 mg o.d.) and treated for 3 months, with visits at monthly intervals. If necessary, treatment was adjusted at each visit to control BP (supine DBP less than or equal to 90 mm Hg): firstly by doubling the dose and secondly, one month later, by the addition of a second drug, a diuretic in the studies versus C or A, a beta-blocker in the study versus D. At 3 months, BP control on monotherapy in the three studies was achieved in the following proportion of patients: 49% with P vs 49% with C; 55% with P vs 48% with A; 72% with P vs 72% with D. Most of the patients controlled by P received 4 mg, about 15% were controlled with 8 mg. A further percentage of patients was controlled with combination therapy, the combination with a diuretic being more effective with P than with C (26 vs 8%) or A (23 vs 10%) and the combination with a beta-blocker being less effective with P than with D (5 vs 13%). The total percentage of patients controlled was greater with P than with C (75 vs 57%, p = 0.016) or A (78 vs 58%, p = 0.006) and there was no significant difference between P and D (78 vs 84%). The drop-out rate due to side-effects was up to 6% with P, similar to that observed with C (4%), A (5%) and D (5%). Most of the complaints reported with P were minor and non-specific, their incidence being similar to that observed with the other drugs. Cough was reported with both P (1%) and C (2%) as well as with A (1%) and D (1%). Compared to these drugs, the biological acceptability of P was good, no case of renal failure being observed.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Perindopril: first-line treatment for hypertension. 269 Nov 29

The clinical efficacy and acceptability of once-daily perindopril (4 to 8 mg) monotherapy and in combination with hydrochlorothiazide (50 mg/day) was studied in mild to moderate stable essential hypertensive patients in 4 centres in Thailand. After 2-4 weeks of placebo run-in period, patients received active treatment for 3 months starting with 4 mg perindopril once daily. Dose titration was at second and third month of active treatment if the supine DBP was > 90 mmHg. The dose was doubled and if necessary, 50 mg/day hydrochlorothiazide was added in the last month. The results in 95 patients showed that the mean reduction in supine SBP/DBP at 1, 2 and 3 months of treatment was 10.3/8.0, 13.2/8.7 and 19.1/13.7 mmHg respectively. At the end of the study, 80 per cent of the patients showed normalisation of the supine diastolic blood pressure (supine DBP < or = 90 mmHg) with 30 per cent receiving combined therapy of perindopril and hydrochlorothiazide. There was no significant change in routine haematology or serum biochemistry except for slight increase of potassium levels in patients receiving 8 mg perindopril monotherapy. The incidence of side effects and withdrawal from treatment were quite low. Cough was the major side effect reported comprising 13.6 per cent with only 1 case withdrawn. The study confirms the previous studies that perindopril had satisfactory antihypertensive efficacy and acceptability profiles.
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PMID:Efficacy and acceptability of perindopril in essential hypertension. 786 13

The purpose of this study was to assess the long-term efficacy and safety of moexipril, a new angiotensin-converting enzyme inhibitor, alone or in combination with hydrochlorothiazide in patients with hypertension. The patient population consisted of 281 hypertensive men and women, 30-84 years old, with seated diastolic BP between 95 and 114 mmHg. The study was a two year multicenter (22 centers), open-label protocol of moexipril monotherapy or combination therapy (with hydrochlorothiazide). Blood pressure, pulse rate, weight, adverse side-effects and laboratory studies were assessed following moexipril dosing at 7.5, 15 or 30 mg once daily or 15-30 mg daily in combination with 12.5 mg hydrochlorothiazide if the DBP was > or = 90 mmHg. The primary measure of efficacy was change from baseline in seated DBP. Secondary outcome measures included changes in seated SBP, heart rate, laboratory parameters and subjective complaints. Following one year of therapy in 183 patients, the BP fell 13/14 mmHg among patients receiving moexipril monotherapy and 18/15 mmHg those receiving combined therapy compared with baseline (P < 0.001 for both). After two years of treatment, reductions were similar in 161 patients. Forty-four (16%) patients were prematurely withdrawn from the study because of inadequate therapeutic response and 34 (12%) secondary to adverse experiences. There were no changes in pulse rate or postural BP reductions. Four adverse side-effects occurred at a frequency exceeding 2% that were possibly or probably attributable to moexipril: fatigue (3%), headache (2%), dizziness (3%) and increased cough (5%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Long-term efficacy and safety of moexipril in the treatment of hypertension. 788 91

Efficacy and acceptability of perindopril (Coversyl) in general practice were evaluated in 23,460 hypertensive patients (52.9% women) during an open six month trial. Patients had essential mild to moderate hypertension (94 mmHg < supine DBP < 115 mmHg) associated or not with obesity (34%), diabetes (12%), hypercholesterolemia (36%), smoking habits (24%). Mean hypertension duration was 6.5 years, 70 p. cent of patients were 50 to 69 years old and 12 p. cent 70 years old or more. Perindopril was started at 4 mg except in older and patients with renal insufficiency (2 mg). If supine DBP remained > 90 mmHg the dose was doubled up to 8 mg/day, then a thiazide diuretic was added. Monotherapy was held in 90 p. cent of cases all along the study, more than 8 over 10 times at 2 or 4 mg/day. Normalized patients (DBP < or = 90 mmHg) were 69.87 and 95 p. cent respectively at the first, third and sixth month. Mean supine SBP and DBP decrease were 27.3 and 18.0 mmHg. Antihypertensive activity was similar in patients taking psychotrope or non steroidal anti-inflammatory agents and in others, as well as in older (> or = 70 years), diabetics and obeses, however with a significantly more frequent bitherapy in these last three sub-groups. Cough, a well known side effect of ACEI led to withdrawal in only 2.6 p. cent of cases. Withdrawals for side-effect were more frequent in older patients (6.1%), in those taking psychotrope (5.3%) or non steroidal anti-inflammatory agents (6.0%) than in diabetics (4.1%) or the others (4.1%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Antihypertensive action, clinical and biological acceptability of perindopril: main results in 23,460 patients with mild to moderate hypertension treated for 6 months in general practice]. 848 Sep 86

The purpose of this study was to evaluate the long-term safety and efficacy of moexipril, a non-sulphydryl angiotensin converting enzyme inhibitor, alone or in combination with hydrochlorothiazide in older patients with hypertension. One hundred and seventy two hypertensive men and women, 65-80 years old, with seated DBP between 95 and 114 mm Hg were studied. The study was a 2 year, multicentre (12 centres), open-label protocol of moexipril monotherapy or combination therapy (with hydrochlorothiazide). Blood pressure, pulse rate, weight, adverse effects and laboratory studies were assessed following moexipril at 7.5 or 15 mg once daily or 7.5 or 15 mg daily in combination with 25 mg of hydrochlorothiazide if the seated DBP remained > or = 90 mm Hg on moexipril monotherapy. The primary measure of efficacy was a change from baseline in seated DBP. Secondary outcome measures included changes in seated DBP, pulse rate, laboratory parameters and adverse side-effects. Following 1 year of therapy in 135 patients, the BP fell 16/14 mm Hg among patients receiving moexipril monotherapy and 27/17 mm Hg for those receiving combined therapy compared with baseline (P < 0.001 for both). After 2 years of treatment, reductions were similar in 120 patients. Nineteen patients (11%) were prematurely withdrawn from the study because of inadequate therapeutic response and 28 (16%) because of adverse experiences. There were no significant changes in pulse rate or postural reductions in BP on either moexipril monotherapy or combination treatment. Three adverse side-effects occurred at a frequency exceeding 2% that were possibly or probably attributable to moexipril or combination therapy: hypotension (2%), dizziness (6%) and increased cough (12%). There were no clinically relevant mean group changes from baseline laboratory values in the treatment groups. In conclusion, these long-term data demonstrate that moexipril, either alone or in combination with hydrochlorothiazide, has long-term anti-hypertensive efficacy and is generally well tolerated in elderly patients with hypertension.
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PMID:Long-term safety and efficacy of moexipril alone and in combination with hydrochlorothiazide in elderly patients with hypertension. 858 66

The objective of this study was to compare the effectiveness of three treatment methods available for treatment of previously medicated patients with mild to moderate hypertension. The comparison was made between adjusting or increasing previous medication and switching the previous drug treatment to lisinopril (CAS 76547-98-3) or lisinopril hydrochlorothiazide (CAS 58-93-5) therapy and in both of these treatment groups the effect of additional intensified health education was tested. An open, randomised, controlled multi-centre study lasting 36 weeks involving 189 doctors and 69 nurses was carried out in 155 centres of primary health care and occupational health care system in Finland. The study population consisted of 1156 patients, age 30-70 years, (mean DBP 95-115 mmHg in the last three to five measurements during follow-up). The number of patients achieving target pressure (DBP < 90 mmHg) at the end of the study, defined daily doses (DDD) of antihypertensive drugs and side-effects in different treatment groups were regarded as the main outcome measures of the study. After exclusions and drop-outs the final analysis was carried out with 900 patients, 419 women (46.6%) and 481 men (53.4%). Patients receiving lisinopril treatment achieved target pressure significantly more often (p < 0.001) than those continuing their previous or adjusted medication at 36 weeks (59.2 and 55.5% vs 40.3 and 42.7%). Only a small additional but statistically non-significant blood pressure lowering effect was achieved with intensified non-pharmacological treatment at weeks 12 and 24, but this difference had disappeared at week 36. The mean DDDs of different antihypertensive drugs did not differ between groups except for female patients on previous or adjusted medication not receiving health education, the mean DDD being significantly (p < 0.05) higher at weeks 24 and 36 in this group. The profile of adverse effects at the end of the study clearly favoured patients on lisinopril treatment except for cough which was reported in 18% of patients vs 10% in the control groups. 81 patients on lisinopril treatment were withdrawn from the study because of cough. The results showed that hypertensive patients with poor treatment control benefit from all three approaches. A greater proportion of patients on lisinopril treatment achieved target pressure and also experienced fewer side effects than those continuing on adjusted previous medication. Intensified personal health education given once a month during six months had only a small additional beneficial effect on reaching the target pressure and this effect was lost in three months after the health education period.
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PMID:Effects of lisinopril or lisinopril/hydrochlorothiazide compared with adjusting of previous medication and intensifying non-pharmacological treatment in patients with mild to moderate hypertension. 907 33

The concept of initiating treatment of mild-to-moderate hypertension with a low-dose combination of reserpine and the thiazide clopamide in comparison to monotherapy with an ACE inhibitor was investigated. A total of 127 adult outpatients with diastolic blood pressure between 100 and 114 mmHg were randomized into this double-blind, parallel group study. After a 2-week wash-out period and a subsequent 2-week placebo run-in period, they were allocated to once-daily treatment with 0.1 mg reserpine plus 5 mg clopamide (R/C), or 5 mg enalapril. If diastolic blood pressure was not normalized after 3 weeks of therapy (i.e. DBP < 90 mmHg), the dosage was doubled from week 4 to 6. The primary efficacy variables were the change from baseline in mean sitting diastolic and systolic blood pressure (DBP/SBP) after 3 weeks of therapy. Secondary variables included the change in DBP and SBP after 6 weeks of therapy, the BP normalization rates at 3 and 6 weeks and, concerning tolerability, the rates of adverse events after 6 weeks of therapy. An intent-to-treat analysis was performed. The reserpine/ clopamide and enalapril groups did not differ with regard to demographic and baseline characteristics (mean age 57 or 58 years, respectively; 63% or 56% males, respectively; mean SBP/DBP after the 2-week placebo period = 156 mmHg/104 mmHg in both groups). After 3 weeks of treatment with one capsule daily, mean SBP/DBP reduction from baseline (24 h after last medication intake) in the R/C combination group was -19.6/ -17.0 mmHg, in the enalapril group -6.1/ -9.5 mmHg (between-group comparison: 2p < 0.01 for both parameters). The normalization rates for DBP (< 90 mmHg) were 64.1% (R/C) and 28.6% (enalapril) (2p < 0.01). Adverse events that were considered possibly or definitely drug-related by the investigator were noted in 11 patients (17.2%) in the R/C group and in 9 patients (14.3%) in the enalapril group (NS). Two patients in the enalapril group discontinued the study prematurely due to adverse events (cough; skin eruption). In the treatment of mild-to-moderate hypertension, a low-dose combination of reserpine and clopamide once a day is considerably more effective than, and as tolerable as, 5-10 mg of enalapril once a day. These findings suggest that treatment with a combination of different antihypertensives with different modes of action in low doses is a rational alternative to conventional monotherapy in the first-line treatment of hypertension. Besides, the "old" reserpine-diuretic regimen also in these days appears to be a rational alternative to "modern" monotherapies.
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PMID:Low-dose reserpine/thiazide combination in first-line treatment of hypertension: efficacy and safety compared to an ACE inhibitor. 936 1

The effects of 2 fixed antihypertensive combination drugs on blood pressure and aortic elastic properties were compared in 2 parallel groups. Twenty-six patients for 6 months received a calcium antagonist plus ACE inhibitor (verapamil SR 180 mg/trandolapril 1 mg (Vera/Tran)) and 25 patients a beta-adrenoceptor antagonist plus diuretic (metoprolol 100 mg/hydrochlorothiazide 12.5 mg (Meto/HCTZ)). In addition to blood pressure (SBP, DBP), carotidofemoral pulse wave velocity (PWV) was assessed non-invasively. Total peripheral resistance (TPR) was determined from cardiac output derived by electrical impedance cardiography. Sitting DBP decreased for -14.4 mmHg following Vera/Tran compared with -9.2 mmHg following Meto/HCTZ (p = 0.02 for difference between treatments). Blood pressure was normalized (i.e. DBP < 90 mmHg) in 69% of patients with Vera/Tran and in 52% with Meto/HCTZ. PWV was lowered with Vera/Tran to a higher extent than with Meto/HCTZ (differences between group means -0.46 to -0.98 m/sec, statistically not significant). Vera/Tran induced a decrease in TPR of about 15% of baseline values, whereas Meto/HCTZ showed no influence. Treatment-related adverse events following Meto/HCTZ were bradycardia and associated symptoms; following Vera/Tran these were cough and edema in 1 case each. In the Meto/HCTZ group, there were more withdrawals/drop-outs (9/25) than in the Vera/Tran group (2/26). The somewhat more intense reduction in PWV with Vera/Tran is indicative of an increase in aortic elastic properties associated with the more potent decrease in BP. In the present study, the combination of calcium antagonist plus ACE inhibitor was found to be an effective and well tolerated antihypertensive regimen and in these respects appears to have some advantages compared with a combination of beta-blocker plus diuretic.
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PMID:Blood pressure and aortic elastic properties--verapamil SR/trandolapril compared to a metoprolol/hydrochlorothiazide combination therapy. 972 95


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