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The role of captopril as single therapy in hypertension and angina pectoris

Authors
Journal
International Journal of Cardiology
0167-5273
Publisher
Elsevier
Publication Date
Volume
33
Issue
2
Identifiers
DOI: 10.1016/0167-5273(91)90356-t
Keywords
  • Clinical Cardiology
Disciplines
  • Medicine

Abstract

Abstract Eighteen hypertensive patients with a resting diastolic blood pressure between 100 and 120 mmHg who also had angina and proven coronary arterial disease entered a dose titration study to evaluate the efficacy of captopril as a single therapy in hypertension and coexisting stable angina. Captopril was administered for 2 weeks at 25 or 50 mg three times daily and the patients evaluated subjectively and by maximal symptom limited treadmill exercise testing. In comparison to placebo captopril 25 mg and 50 mg dosage increased time to 1 mm ST depression from 188.2 ± 24.4 sec on placebo to 337.6 ± 29.5 and 364.2 ± 36.2 sec respectively ( P < 0.01). The maximum ST segment depression was reduced from 2.5 ± 0.25 mm on placebo to 1.4 ± 0.22 mm on captopril 25 mg and 1.2 ± 0.30 mm on captopril 50 mg ( P < 0.01). Exercise duration increased from 310.3 ± 21.4 sec on placebo to 438.3 ± 27.3 sec on captopril 25 mg and to 460.9 ± 26.5 sec on captopril 50 mg ( P < 0.01). The resting systolic blood pressure decreased from 184.1 ± 4.7 mmHg on placebo to 159 ± 4.2 mmHg on captopril 25 mg and to 150.9 ± 4.6 mmHg on captopril 50 mg (< 0.01). Similarly, diastolic blood pressure decreased from 111.6 ± 2.1 mmHg on placebo to 93.8 ± 1.3 mmHg on captopril 25 mg and to 90.0 ± 1.7 mmHg on captopril 50 mg ( P < 0.01). Anginal attacks decreased from 17.6 ± 3.1 on placebo to 6.9 ± 1.6 on captopril 25 mg and 4.0 ± 1.1 on captopril 50 mg ( P < 0.01). Thus captopril is an effective monotherapy for hypertensive patients with chronic stable angina. These results show that captopril has both anti-anginal as well as anti-ischaemic effects on exercise-induced ST segment shift when these two conditions coexist.

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