Captopril versus nifedipine as monotherapeutic modalities in systemic hypertension

ABSTRACT

In a trial to compare the hypotensive efficacy of captopril [25 mg orally bid for one month] vs nifedipine [10 mg orally tid for one month] in hypertensive patients with and without chronic obstructive pulmonary disease [COPD], as well as the impact of either of these therapeutic modalities on ventilatory function, arterial blood gases [PO[2] and PCO[2]], blood pH, blood urea, serum creatinine, plasma Na and K, and fasting blood glucose [FBG], forty eight patients with mild to moderate essential hypertension [24 with COPD and 24 without] were included in the present work. Captopril insignificantly reduced systolic, diastolic, and mean arterial pressure [S.B.P., D.D.P and M.A.P.] in hypertensive patients without COPD. In those with COPD the latter two were poorly, yet significantly reduced. Nifedipine, however, significantly reduced the three parameters in hypertensive patients with and without COPD. Captopril significantly increased forced expiratory volume in the 1st second [FEV[1]], forced expiratory flow 25% [FEF[25%]], [FEF [50%] in patients without COPD, while FEF[25%] was the only significantly increased parameter in those with COPD. Blood pH, PO[2], and PCO[2] were insignificantly affected by captopril in both groups. On the other hand, nifedipine did not significantly affect either ventilatory function parameters or arterial blood gases in patients without COPD. In those with COPD, it only significantly increased FEV[1] and peak expiratory flow rate [PEFR], and decreased PO[2]. In both hypertensive groups captopril significantly increased plasma Na and K, while nifedipine did not. Blood urea and serum creatinine were not significantly affected by either drug among the studied groups. FBG was significantly elevated in both groups receiving nifedipine, while insignificantly affected in those receiving captopril. It can be concluded that in mild to moderate hypertension captopril [25 mg orally bid for one month] has no or poor effect as a hypotensive drug with at least no deleterious effects on ventilatory function, arterial blood gases, blood pH, blood urea, serum creatinine, and F.B.G., but increases plasma Na and K in patients with or without COPD. Nifedipine [10 mg orally tid for one month] is a potent hypotensive drug with a significant bronchodilating effect in patients with COPD but significantly decreases PO[2] and increases FBG with insignificant effects on blood urea, serum creatinine, and plasma Na or K