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

In a randomized double-blind multicentre study the efficacy (lowering diastolic blood pressure less than or equal to 90 mmHg) of urapidil, a postsynaptic alpha-blocker with central action, was compared with that of the angiotensin converting enzyme inhibitor captopril. Two hundred and ninety-five essential hypertensives (World Health Organization stages I-II; 140 males, 155 females; mean age 51 years) were treated for 12 weeks with either 30-90 mg urapidil twice a day or 12.5-50mg captopril twice a day. Supine blood pressure values (mmHg, means +/- s.d.) at the end of the 12-week treatment period fell in the urapidil group (n = 142) from 175 +/- 19/103 +/- 6 to 154 +/- 17/89 +/- 9 (P less than 0.001), in the captopril group (n = 153) from 175 +/- 19/103 +/- 6 to 154 +/- 19/90 +/- 9 (P less than 0.001), representing responder rates of 62% for urapidil and 58% for captopril. The results demonstrate that two antihypertensive medications with different modes of action control blood pressure with equal efficacy. A dose decrease was possible in 20% of each group, but a dose increase was necessary in 39% of the urapidil and 44% of the captopril group.

RCT Entities:   Population Interventions Outcomes