Summary
In a multicentre study by general practitioners, the antihypertensive efficacy of urapidil a postsynaptic α-blocker with central action, was compared with that of the angiotensin-converting enzyme inhibitor captopril.
The study was of a double-blind, randomised parallel-group design. Following a 2- week washout and placebo phase, 295 essential hypertensives (WHO I/I I) were treated for 12 weeks with either urapidil or captopril, initially with urapidil 60mg twice daily or captopril 25mg twice daily, with the possibility of adjusting the dose according to blood pressure response after 2 weeks of treatment [diastolic blood pressure (DBP) 90 mm Hg or less: reduction of urapidil to 30mg twice daily or captopril to 12.5mg twice daily; DBP 91 to 99mm Hg: döse unchanged; DBP 100mm Hg or more: dose increased to urapidil 90mg twice daily or captopril 50mg twice daily].
Blood pressure values at the end of the 12- week treatment period dropped significantly in the urapidil group (n=142; all dosages) from 175/103mm Hg to 154/89mm Hg (p < 0.001) and in the captopril group (n=153; all dosages) blood pressure decreased from 175/103mm Hg to 154/90mm Hg (p < 0.001), corresponding to 62% and 58% urapidil and captopril responder rates (DBP ≤ 90mm Hg), respectively. The responder rate at 12 weeks under urapidil therapy was 30% for the initial, 17% for the lower and 15% for the higher dose; the respective values for captopril were 28, 16 and 14%.
The computer-assisted frequency distribution of the patients with controlled DBP (≤ 90mm Hg) over the entire study duration demonstrated comparable efficacy for both drugs. Side effects were observed in 45 patients of the urapidil group and in 18 patients of the captopril group (vertigo, nausea, headache). The results revealed that these two antihypertensive agents with different modes of action controlled blood pressure with equal efficacy.
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Rosenthal, J., Haerlin, R., Schäfer, N. et al. Efficacy of Urapidil in the Management of Essential Hypertension. Drugs 35 (Suppl 6), 147–155 (1988). https://doi.org/10.2165/00003495-198800356-00020
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DOI: https://doi.org/10.2165/00003495-198800356-00020