Efficacy and safety of spirapril, a new ace-inhibitor, in elderly hypertensive patients

Abstract

Objective: To compare the safety, efficacy, tolerability and duration of the antihypertensive effect of an ACE-inhibitor spirapril 3 mg or 6 mg in elderly (≥ 60 y) hypertensive patients in a multicentre, observational, double-blind randomised study.

Methods:

After a four-week placebo period, 39 patients were randomised to six weeks of treatment with spirapril 3 mg and 47 patients with spirapril 6 mg.

Results:

In the sitting position the mean (SD) decrease in systolic blood pressure (SBP) was 12(15) mmHg (95% confidence interval 7 to 17 mmHg) and in dia- stolic blood pressure (DBP) 10(7) mmHg (8 to 12 mmHg) in the 3-mg group and 10(13) mmHg (6 to 14 mmHg) and 9(7) mmHg (7 to 11 mmHg), respectively, in the 6-mg group (P < 0.001 compared to placebo period in both groups). Spirapril 3mg and 6 mg produced DBP ≤ 90 mmHg or a fall ≥ 10 mmHg in 53% and 51% of the patients, respectively. DBP was ≤ 90 mmHg in 36% and SBP ≤ 160 mmHg in 67% of the patients taking 3 mg and in 26% and 63% of the patients taking 6 mg spirapril. The most commonly reported adverse effects were cough (13–17%), dizziness, headache and insomnia. A trend to a more frequent adverse effects was observed in patients receiving spirapril 6 mg. Spirapril was both cholesterol- and glucose-neutral.

Conclusion:

According to our study, spirapril 3mg seems to be a suitable starting dose for the treatment of hypertension in the elderly patients.