Spirapril in the Treatment of Moderate to Severe Hypertension. One-year Multicentre Czech and Slovak Study

Overview

The one-year open study investigated the therapeutic effect and tolerance of spirapril in 171 patients with moderate hypertension in 11 centres in the Czech and Slovak Republic.The antihypertensive effectiveness was investigated after 4 weeks, l2 weeks and after 52 weeks. In this summary we are presenting only the results recorded after one year. The study was completed after one year by 139 patients, 120 of them (96.3%) with a normal diastolic pressure of 90 mm Hg or less. The study was not completed by 32 patients (18.8%). Because of lack of response to treatment 9.4%, for undesirable effects 4.7% were eliminated from the study by the authors as well as 3.5% on account of various reasons (moved to another domicile, poor cooperation) and 1.2% were eliminated because they did not adhere to the protocol. According to the analysis „intention to treat" the diastolic pressure was reduced to normal levels by monotherapy with spirapril in 25.1% of the baseline group, a combination of spirapril with bopindolol led to normalization of the pressure in another 38.0% of patients and in 7.0% patients normalization of the diastolic pressure was achieved by a combination of spirapril and hydrochlorothiazide, i.e. a total of 70.1% of the initial group had a normal diastolic pressure after one year. In another 9.4% of the baseline group the diastolic pressure declined by 10 mm Hg, however, not to a normal level. Thus normalization or effective control of the diastolic pressure was achieved after one year in 79.6% of patients according to the „intention to treat" analysis. Combination of spirapril and bopindolol proved very effective. Patients where it was necessary to combine spirapril with bopindolol or hydrochlorothiazide had significantly higher baseline blond pressure values. During treatment in none of the groups changes of blond lipids, potassium, uric acid, haemogram, liver tests or creatinine were recorded. Treatment was well toleraned and undesirable effects were rare (most frequent were cough in 3.5% and vertigo also in 3.5%). The results of the investigation show tkat spirapril is an effective and well tolerated ACE inhibitor in the treatment of hypertension and its combination with bopindolol seems equally suitable as the combination of spirapril with hydrochlorothiazide.

Key words:
moderate hypertension - treatment - spirapril - ACE inhibitor.