Treatment of hypertensive and hypercholesterolaemic patients in general practice. The effect of captopril, atenolol and pravastatin combined with life style intervention.

OBJECTIVE: To elucidate the effect on blood pressure and blood lipids of an angiotensin converting enzyme inhibitor (captopril), and a beta-receptor blocking agent (atenolol), given alone or in combination with a cholesterol reducing drug, the beta-hydroxy-methylglutaryl-coenzyme A reductase inhibitor pravastatin, in patients who were also encouraged to improve their lifestyle. DESIGN: A longitudinal study consisting of three phases. I: Lifestyle intervention alone. II: Continued lifestyle intervention combined with captopril or atenolol. III: Continued lifestyle intervention combined with the same drugs as in phase II and in addition pravastatin or placebo. SETTING: Fifty-four general practice surgeries in Norway. PARTICIPANTS: Hypertensive patients, 210 females and 160 males, treated or untreated with antihypertensive drugs with a sitting diastolic blood pressure between 95 and 115 mmHg and a serum total cholesterol between 6.5 mmol/l (7.0 for those age 60-67 years) and 9.0 mmol/l. RESULTS: The antihypertensive effect of captopril and atenolol was not influenced by concurrent administration of pravastatin. The effect of pravastatin was not limited by concurrent medication with captopril or atenolol. Improvement in lifestyle seemed to reduce the need for supplementary treatment with diuretics. CONCLUSION: Pravastatin can be used in combination with captopril or atenolol in the treatment of hypertensive and hypercholesterolaemic patients.

Prophylactic treatment of angina pectoris. A double-blind cross-over comparison of alprenolol and pentanitrol.

Twenty-one patients with angina pectoris took part in a double-blind cross-over comparison of alprenolol (an adrenergic beta-blocker), pentanitrol (pentaerythritol tetranitrate), and placebo. Two-thirds of the patients were clinically improved on alprenolol 100 mg. four times daily, which was found to be significantly better than pentanitrol 30 mg. four times daily and placebo. There was also an indication of reduced severity of anginal attacks during alprenolol therapy. It is concluded that success in at least two-thirds can be expected with alprenolol. No serious complications or side-effects occurred during alprenolol treatment.