Oral therapy with combined enalapril, prazosin and hydrochlorothiazide in the acute treatment of severe hypertension in Nigerians

Objective: The efficacy, safety, tolerability and speed of onset of the hypotensive action of the combination of oral enalapril (10 mg) prazosin (1 mg) and hydrochlorothiazide (50 mg) has been assessed in 12 Nigerians with severe hypertension (Diastolic BP greater than or equal to 115 mmHg). Patients: The ages of the patients ranged from 30-60 years, and the serum creatinine from 52-732 mu mol . l(-1). The initial blood pressure was 200/130 mmHg. Results: The combination significantly reduced systolic and diastolic blood pressure respectively. The hypotensive action appeared within 0.5 h and led to a fall in BP to 175/120 mmHg, and the peak action occurred at 4 h, when the BP was 138/99 mmHg, and it persisted upto 24 h (160/101 mmHg). Despite the significant fall in blood pressure, no reflex tachycardia was observed. Transient dizziness was seen in 2 patients, but otherwise all claimed improvement in clinical status and a clearer sensorium. Conclusion: The combination may be a useful oral treatment for the rapid control of severe hypertension in Blacks.