[Comparative effects of captopril and atenolol on lipid metabolism in hypertensive hypercholesterolemic patients treated with pravastatin. A multicenter controlled trial]

Abstract

Objectives: A randomized double-blind trial was conducted in hypertensive subjects with hypercholesterolemia treated with pravastatin in order to compare the effects of captopril and atenolol on lipid metabolism.

Methods: After a pre-inclusion period, 147 eligible subjects (64 men and 83 women, age range 32-74 years) were randomized into two groups and given, in a double-blind trial, either captopril (50 mg/d) or atenolol (50 mg/d) for 6 months. The controlled trial was followed by an open trial in 120 subjects for 6 more months. Laboratory tests for lipid metabolism were performed at inclusion and at 6 months.

Results: Control of blood pressure was satisfactory and similar in the two groups. Lipid tests were performed both in local and a centralized laboratory with good interlaboratory correlations. High density lipoprotein (HDL)-cholesterol remained unchanged in the captopril group declined slightly in the atenolol group. Total cholesterol increased moderately in both groups. Triglycerides increased somewhat in the captopril group and significantly more in the atenolol group. These results were maintained during the open trial. Most of the undesirable effects were benign and did not require treatment.

Conclusion: The effects of captopril and of atenolol are not diminished in combination regimens with pravastatin. The antihypertensive efficacy was similar for the two treatments, but the effect on lipid metabolism was more favorable with captopril.