[Captopril in mild and moderate arterial hypertension resistant to diuretic therapy. A multicenter study]. / Captopril na hipertensão arterial level e moderada resistente à diureticoterapia. Estudo multicêntrico.

PURPOSE: To evaluate the antihypertensive effect of captopril in mild and moderate hypertensive patients uncontrolled with diuretics. METHODS: Low dose of captopril (25 to 50 mg) bid were associated during 9 weeks in 120 patients previously treated with 100 mg of hydrochlorothiazide. A subgroup of patients (74) were followed additionally for 3 weeks with the same dose of the drugs administered as a single dose. The patients were clinically evaluated after two weeks placebo, and each three weeks of active drugs. Blood pressure normalization were considered when diastolic arterial pressure was < or = 90 mmHg. Laboratory tests were measured before diuretic, before captopril and at the end of combined twelve weeks treatment. RESULTS: After 15 days washout, the baseline supine arterial pressure, 168 +/- 2/ 109 +/- 1 mmHg decrease significantly with diuretic to 151 +/- 1/ 101 +/- 1 mmHg and the drop was further increased with captopril b.i.d., with a mean dose of 44 +/- 1 mg, to 137 +/- 1/ 90 +/- 1 mmHg. Blood pressure normalization was obtained in 58% patients with captopril b.i.d. and in 63% as single dose. Blood pressure normalization was achieved in 63% of non-white patients and in 56% patients over 45 years old. Plasmatic potassium decreased significantly with diuretic and did not recovered when captopril was associated. CONCLUSION: Our results indicate that the addition of low dose of captopril twice or once a day may result in a marked additional blood pressure reduction in cases of insufficient control by the diuretic alone.

"Cor pulmonale" devido a obstrucao cronica das vias aereas na infancia. / Cor pulmonale secondary to chronic obstruction of the airways in childhood

Os autores apresentam um caso de cor pulmonale e insuficiencia cardiaca congestiva, consequentes a obstrucao cronica de vias aereas superiores por hipertrofia de amigdalas e adenoides, bem como, revisao de 58 casos descritos na literatura. Deve ser ressaltada a raridade do caso e a importancia do reconhecimento precoce da sindrome obstrutiva com tratamento imediato para beneficio do paciente