Efficacy of urapidil in the management of essential hypertension. A comparison with captopril.

In a multicentre study by general practitioners, the antihypertensive efficacy of urapidil, a postsynaptic alpha-blocker with central action, was compared with that of the angiotensin-converting enzyme inhibitor captopril. The study was of a double-blind, randomised parallel-group design. Following a 2-week washout and placebo phase, 295 essential hypertensives (WHO I/II) were treated for 12 weeks with either urapidil or captopril, initially with urapidil 60 mg twice daily or captopril 25mg twice daily, with the possibility of adjusting the dose according to blood pressure response after 2 weeks of treatment [diastolic blood pressure (DBP) 90 mm Hg or less: reduction of urapidil to 30 mg twice daily or captopril to 12.5mg twice daily; DBP 91 to 99 mm Hg: dose unchanged; DBP 100 mm Hg or more: dose increased to urapidil 90 mg twice daily or captopril 50 mg twice daily]. Blood pressure values at the end of the 12-week treatment period dropped significantly in the urapidil group (n = 142; all dosages) from 175/103 mm Hg to 154/89 mm Hg (p less than 0.001) and in the captopril group (n = 153; all dosages) blood pressure decreased from 175/103 mm Hg to 154/90 mm Hg (p less than 0.001), corresponding to 62% and 58% urapidil and captopril responder rates (DBP less than or equal to 90 mm Hg), respectively. The responder rate at 12 weeks under urapidil therapy was 30% for the initial, 17% for the lower and 15% for the higher dose; the respective values for captopril were 28, 16 and 14%.(ABSTRACT TRUNCATED AT 250 WORDS)

RCT Entities:   Population Interventions Outcomes