Zofenopril plus hydrochlorothiazide combination in the treatment of hypertension

Abstract

Introduction Zofenopril is a highly lipophilic ACE inhibitor, characterized by long-lasting tissue penetration and sustained cardiac ACE inhibition, indicated for the treatment of hypertension and myocardial infarction. Hydrochlorothiazide is a diuretic medication often used to treat high blood pressure. Aim The aim of this study was to compare the antihypertensive effect of the combination of zofenopril plus hydrochlorothiazide versus zofenopril monotherapy in patients with essential hypertension. Materials and Methods Patients with mild to moderate essential hypertension, aged 18 to 75 years, were randomized at a ratio of 2:1:1 to treatment with zofenopril 30 mg plus hydrochlorothiazide 12.5 mg or monotherapy with zofenopril 30 mg or hydrochlorothiazide 12.5 mg for 12 weeks in an international double-blind study. Systolic BP and DBP were measured by mercury sphygmomanometry, and changes associated with treatment were calculated. Results Two hundred forty-six patients (139 men, 107 women; mean age 54 years) were included in the analysis. Mean baseline cardiovascular risk was similar in the zofenopril plus hydrochlorothiazide group and the zofenopril monotherapy group (7% vs 9%). DBP and SBP reductions with treatment were significantly greater with combination treatment than with monotherapy. Cardiovascular risk reduction at the end of the 12 weeks of double-blind treatment was greater in the zofenopril plus hydrochlorothiazide group than in the zofenopril monotherapy group. Conclusion The fixed combination of zofenopril plus hydrochlorothiazide may have a particular place in the treatment of high-risk or monotherapy-treated uncontrolled hypertensive patients requiring a more prompt, intensive and sustained BP reduction.