Efficacy of amlodipine plus benazepril vs amlodipine plus hydrochlorothiazide on the treatment of essential hypertention

Objective To evaluate the clinic efficacy of amlodipine plus benazepril vs amlodipine plus hydrochlorothiazide on mild-to-moderate essential hypertension.Methods From January to September in 2012,276 patients who were diagnosed as mild-to-moderate essential hypertention for the first time in outpatient of our hospital were enrolled,and they were 60-75 years old,156 male and 120 female.All the 276 patients were randomized to the amlodipine plus benazepril (group A,n =92),amlodipine plus 12.5 mg hydrochlorothiazide (group B,n =92) and amlodipine plus 25 mg hydrochlorothiazide (group C,n =92).All patients were given 5 mg amlodipine,those whose blood pressure were above blood pressure goal(＞ 140/90 mm Hg) were given 10 mg benazepril in group A,while those whose blood pressure were above blood pressure goal were given 12.5 mg hydrochlorothiazide in group B,and those whose blood pressure were above blood pressure goal were given 25 mg hydrochlorothiazide in group C.The results of blood pressure,adverse events and the percentages of control in 12 weeks were recorded.Results There were only 98 patients (35.5％)whose blood pressure were below the blood pressure goal in all patients who took only 5 mg amlodipine.Twelve weeks after the joint treatment of antihypertensive drugs,the total efficiency were 94.5％ in group A,89.1％ in group B and 95.7％ in group C.No significant difference in efficacy was found among the groups (P ＞ 0.05).Between group B and group C,when hydrochlorothiazide increased from 12.5 mg to 25 mg,the efficacy didn' t increased,there were significant differences in drug related adverse event rates among the group C and group A,group B (P ＜ 0.05,respectively).No significant difference in drug related adverse event rates was found between group A and group B (P ＞ 0.05).Conclusions The combination therapy of amlodip recommended.However,large dosage of hydrochlorothiazide has more adverse effects,so small dosage of diuretic is recommended in joint treatment of essential hypertention.ine with benazepril or amlodipine with small dosage of hydrochlorothiazide is similar in lowering BP,so both joint regimes should been Key words: Amlodipine ;  Benazepril ;  Hydrochlorothiazide;  Essential hypertention