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Combined treatment with captopril, hydrochlorothiazide and pravastatin in dyslipidemic hypertensive patients.
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OBJECTIVES: Hypertension and hypercholesterolemia frequently coexist, necessitating concurrent treatments for both disorders. The present study aimed at evaluating the efficacy, the safety, and the toleration of captopril, an ACE inhibitor, hydrochlorothiazide, a diuretic, and pravastatin, a HMG-CoA reductase inhibitor co-administered in hypertensive patients in general practice. DESIGN: The patients were followed for 16 weeks and asked to comply with a lipid lowering diet for the whole period. Captopril, 50 mg/once daily, was administered alone for the first 4 weeks. Hydrochlorothiazide, 25 mg/day, was added after 4 weeks if required. Pravastatin treatment (20 mg/day) was started at the 8th week of the study and its dose was doubled 4 weeks later if needed. PATIENTS: A total of 603 patients with hypertension (diastolic blood pressure > or = 95 mmHg) and dyslipidemia (total cholesterol > 6.5 mmol/l) were included. SETTING: The study was performed in general practice by 230 physicians. MAIN OUTCOME MEASURE: Determination of blood pressure, circulating levels of total cholesterol, HDL-cholesterol and triglycerides, and blood chemistry for safety monitoring. RESULTS: At the end of the trial 75.1% of patients had their diastolic blood pressure < or = 90 mmHg and 43.5% a total cholesterol level < 6.5 mmol/l. The overall incidence of adverse events was 21.7%, leading to withdrawal in 10.9% of the total number of patients. The combined treatments had no deleterious effect on safety variables. CONCLUSIONS: Captopril, hydrochlorothiazide and pravastatin are effective and well tolerated medications to treat dyslipidemic hypertensive patients.
Adult, Aged, Angiotensin-Converting Enzyme Inhibitors, Anticholesteremic Agents, Antihypertensive Agents, Captopril, Combined Modality Therapy, Diuretics, Drug Therapy, Combination, Enzyme Inhibitors, Female, Humans, Hydrochlorothiazide, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hyperlipidemias, Hypertension, Male, Middle Aged, Pravastatin, Prospective Studies, Sodium Chloride Symporter Inhibitors
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