A double-blind, positively controlled, forced dose titration
study comparing the efficacy and safety of atenolol, captopril,
and verapamil sustained release as single agents in the treatment of black patients with mild to moderate hypertension (diastolic blood pressure, 95 to 114 mm Hg) was conducted. A total of
394 patients were randomized to one of the three therapies. Mean
blood pressures during a 2- to 4-week placebo treatment period
(baseline) ranged from 100.4 to 100.7 mm Hg diastolic and 151.7
to 152.5 mm Hg systolic for the three groups. Of the patients, 355
(of whom 345 had assessable data) completed the first treatment
period, which consisted of therapy with either 50 mg/d of atenolol, 25 mg every 12 hours of captopril, or 240 mg/d of verapamil
sustained release. During the second 4-week treatment period,
which 319 patients completed (307 assessable), half of the patients had their antihypertensive medication increased and the
other half continued the same dose. Goal blood pressure was
defined as a supine diastolic pressure of less than 90 mm Hg or a
10—mm Hg or greater drop in supine diastolic blood pressure
from pretreatment levels. Atenolol, captopril, and verapamil sustained release therapy was associated with goal blood pressure
achievement during the first treatment period 55.1%, 43.8%, and
65.2% of the time, respectively, and during the second treatment
period 59.6%, 57.1%, and 73.0% of the time. Side effects were
minimal and comparable for all three drugs.
(Arch Intern Med. 1990;150:1707-1713)
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