LISINOPRIL VERSUS HYDROCHLOROTHIAZIDE IN MILD-TO-MODERATE SYSTOLIC DIASTOLIC OR ISOLATED SYSTOLIC HYPERTENSION IN THE ELDERLY

This double-blind, randomized, multicenter study was designed to compare the efficacy and tolerability of lisinopril and hydrochlorothiazide (HCTZ) in elderly patients (greater-than-or-equal-to 65 years old) with either mild-to-moderate systolic/diastolic hypertension (SDBP greater-than-or-equal-to 95 less-than-or-equal-to 120 mmHg) or isolated systolic hypertension (SSBP > 160 mmHg, SDBP < 90 mmHg) and creatinine clearance levels greater-than-or-equal-to 30 ml/min. At the end of a 2-week placebo run-in period, 96 patients were randomized in a 1:1 mode to receive either lisinopril 10 mg/day or HCTZ 12.5 mg/day. During the 12-week study, the doses of lisinopril and HCTZ were doubled every 4 weeks for nonresponders to a maximum of 40 and 50 mg/day, respectively. A positive response was defined as sitting diastolic blood pressure less-than-or-equal-to 90 mmHg for systolic/diastolic hypertension and as sitting systolic blood pressure less-than-or-equal-to 140 mmHg for isolated systolic hypertension. Mean decreases from baseline in systolic and diastolic blood pressures were significant (P less-than-or-equal-to 0.01) in both treatment groups. Both drugs were generally well tolerated; however, patients treated with HCTZ experienced more adverse effects. Moreover, mean serum potassium levels decreased significantly in the HCTZ group. No serious adverse events were reported in either group. Lisinopril has been shown to be an effective, well-tolerated angiotensin-converting enzyme inhibitor in elderly patients.