Efficacy and Safety of Quinapril 40mg Once Daily as Monotherapy for Patients with Poorly Controlled Hypertension: The EUREKA Study.

Objective: We assessed the efficacy and safety of quinapril 40mg once daily for treating essential hypertension in patients with poorly controlled hypertension who were using other angiotensin-converting enzyme (ACE) inhibitors, or in those who needed to take more than one tablet a day of the ACE inhibitor to lower blood pressure, or in those who needed to start antihypertensive therapy with maximum doses of other drugs because of the severity of hypertension. Design: Prospective, observational, noncomparative, open-label. Methods: A total of 6082 patients of both genders, aged ≥40 years, received a single daily oral dose of quinapril 40mg for a period of 8 weeks. The primary end-point parameter of efficacy was the percentage of patients with adequate control of blood pressure, which was defined as systolic blood pressure (SBP) ≤140mm Hg and diastolic blood pressure (DBP) ≤90mm Hg. For the diabetic group the definition was 130/85mm Hg. Tolerability and safety of antihypertensive drugs was assessed by physical examination and detection of adverse effects potentially related to antihypertensive medication. Results: At the end of the 8-week treatment period with quinapril, adequate control of DBP, SBP and both was found in 90, 56 and 54% of patients, respectively, with a mean difference of 25mm Hg for SBP and of 15mm Hg for DBP as compared with baseline. In hypertensive patients with diabetes mellitus (n = 1269) and in patients previously treated with other ACE inhibitors (n = 2083), quinapril therapy was also associated with statistically significant decreases in mean DBP and SBP (p < 0.0001). A total of 42 adverse events were recorded. No patient failed to complete the study because of adverse events. Conclusions: Quinapril 40mg significantly lowered blood pressure, achieving adequate control of DBP in up to 90% of patients with moderate essential hypertension previously unsuccessfully controlled. [ABSTRACT FROM AUTHOR]