In a nutshell
This paper compared the effect of zofenopril or irbesartan (Avapro) plus a thiazide diuretic on blood pressure in arteries of elderly patients. A combination of a thiazide diuretic plus zofenopril or irbesartan was found to be effective in lowering blood pressure.
Some background
Systolic blood pressure is the blood pressure when the heart beats. High systolic blood pressure (greater than 140 mmHg) in the arteries is more common in the elderly. Studies have shown that lowering blood pressure can help reduce mortality. Various groups of drugs such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB) and thiazide diuretics are used to lower blood pressure. Zofenopril is an ACE inhibitor, while irbesartan is an angiotensin receptor blocker. It is believed that combining a thiazide diuretic with an ACE inhibitor may have similar effects on blood pressure to a combination of a thiazide diuretic and ARB.
Methods & findings
107 patients who received zofenopril daily and 109 patients who received irbesartan daily were analysed. All patients received 12.5 mg of the thiazide diuretic, hydrochlorothiazide, daily. Patients were followed-up for 18 weeks.
After 6 weeks, blood pressure in the arteries were reduced by 7.7 mmHg in patients receiving zofenopril. Blood pressure in the arteries reduced by 7.9 mmHg in patients receiving irbesartan.
A similar proportion of patients who received zofenopril or irbesartan achieved a systolic blood pressure of less than 135 mmHg at 6 weeks. At 18 weeks, a greater number of patients receiving zofenopril (68.2%) achieved a systolic blood pressure of less than 135 mmHg compared to patients receiving irbesartan (56%).
The decrease in blood pressure at night was also similar for patients receiving zofenopril or irbesartan.
4.4% of patients treated with zofenopril and 6.0% of patients treated with irbesartan experienced side effects.
The bottom line
The authors concluded that both a combination of zofenopril or irbesartan plus a thiazide diuretic was effective and safe in controlling blood pressure in elderly patients.
What’s next?
Consult your doctor about receiving a thiazide diuretic in combination with an ACE inhibitor or ARB if your systolic blood pressure is high.
Published By :
Journal of hypertension
Date :
Dec 23, 2015
