Mild hypertension in the elderly. A comparison of prazosin and enalapril.

In a single-blind, crossover study, prazosin and enalapril monotherapies were evaluated in 15 patients, aged 55 years or older (average age, 64 years), with mild hypertension (sitting diastolic blood pressure between 90 and 104 mm Hg). After eight weeks of placebo administration, patients were randomly assigned to treatment with prazosin or enalapril and then treated with the alternate drug after a second eight-week placebo washout period. The dose was titrated from 1 mg to a maximum of 10 mg twice daily of prazosin and from 2.5 mg to a maximum of 20 mg twice daily of enalapril to achieve a reduction in diastolic blood pressure to less than 85 mm Hg, with a decrease of at least 10 mm Hg based on clinical measurements of blood pressure. Patients received maintenance therapy with each medication for at least eight weeks. The response to therapy was then evaluated with two-hour periods of automated blood pressure monitoring. Average systolic and diastolic blood pressures for all patients during these two-hour monitoring periods decreased by 10.3 +/- 1.9/8.3 +/- 1.5 mm Hg during prazosin therapy and by 9.0 +/- 5.1/5.8 +/- 3.4 mm Hg during enalapril therapy. All patients responded to one of the two drugs, but only 50 percent responded to both. Side effects were generally mild and transient, and no significant metabolic effects were observed. Both prazosin and enalapril were effective and well tolerated in this population of elderly patients with mild hypertension.

RCT Entities:   Population Interventions Outcomes