Adrianne Anderson

CLINICAL EFFICACY OF PERINDOPRIL IN HYPERTENSION

1. Perindoprils effectiveness in mild to moderate hypertension was evaluated in three studies.

Interaction of Enalapril with Sodium Restriction, Diuretics, and Slow-Channel Calcium-Blocking Drugs

While monotherapy sometimes controls blood pressure (BP), it is often essential to add a second drug for adequate control. This study examined in a factorial fashion the interaction of enalapril with some commonly used antihypertensive therapies. There were between 10 and 16 patients in each study, and the patients had responded in part to the two drugs used. Enalapril and sodium restriction lowered BP 12 +/- 3/11 +/- 2 and 4 +/- 2/3 +/- 1 mm Hg, respectively. The effects of the two therapies were additive, and there was no interaction. Enalapril and hydrochlorothiazide lowered BP 11 +/- 3/8 +/- 3 and 8 +/- 2/6 +/- 2 mm Hg, respectively. The effect of the two drugs together indicated a positive interaction of 4 +/- 2/3 +/- 1 mm Hg (p less than 0.05). Enalapril and nifedipine both lowered BP (10 +/- 2/8 +/- 1 and 11 +/- 3/8 +/- 1 mm Hg). The two drugs combined had a strongly positive interaction of 10 +/- 3/7 +/- 2 mm Hg (p less than 0.001). Enalapril can be used with the other therapeutic methods tested. If a converting enzyme inhibitor does not reduce BP adequately, it appears appropriate to add a thiazide diuretic or a slow-channel calcium-blocking drug. The mechanism of the positive interaction with diuretics probably reflects an effect on the renin-angiotensin system, but the explanation for the synergism with slow-channel calcium-blocking drugs is unclear.

THE EFFECT OF KETANSERIN IN ESSENTIAL HYPERTENSION

1. Ketanserin, a 5HT2‐receptor blocking drug was given to 17 patients with essential hypertension.

Effect of Pravastatin, Cholestyramine or their Combination in the Treatment of Hypercholesterolaemia in Elderly Hypertensive Patients

Summary30 elderly patients (27 male, 3 female) with treated essential hypertension entered a crossover factorial study to determine the effectiveness of pravastatin (10 and 20 mg/day), cholestyramine (4 or 8 g/day) or their combination in the treatment of hypercholesterolaemia (serum cholesterol 5.5 to 7.5 mmol/L). Pravastatin was well tolerated, but significant dose-related adverse effects were observed with cholestyramine (30% with 8 g/day). Both drugs lowered cholesterol and low density lipoprotein (LDL) cholesterol and caused small rises in high density lipoprotein (HDL) cholesterol, leading to improvement in the various calculated ratios. Triglycerides fell with pravastatin but were not altered by cholestyramine. Approximately 75% or more of the total fall in cholesterol was achieved with the lower dose of both drugs. The combination of the 2 drugs was more effective than either drug alone and the combination of the 2 lower doses was more effective than the higher dose of either drug. Thus, this study infers that the use of low doses of the 2 drugs is a more effective way to reduce cholesterol than progressing to higher drug doses.