Clinical usefulness of tripamide, a diruetic hypotensive agent, was evaluated by a double blind comparative method in 33 elderly essential hypertension of 60 years or more (average age, 65.9) and those of 59 younger patients uder 60 years (average age, 50.0).
A hypotensive effect was considered present when a decrease of 20/10mmHg in systolic/diastolic pressure or a decrease of 13mmHg or more in mean pressure was obtained. This fall in blood pressure was demonstrated in 84.8% of elderly patients and 59.3% of younger ones, the rate being higher in the elderly than in the younger patients (p<0.05). However, the average change of blood pressure was 32.0/13.2mmHg for elderly patients and 26.9/11.2mmHg for younger patients. There was no significant difference between the two age groups.
Hematological tests showed no significant changes, and hemoconcentration was not noted in either of the two age groups. Biochemical studies revealed that serum Cl
- and alkaline posphatase were decreased, and serum urea nitrogen and uric acid were elevated in elderly patients. In younger patients serum Cl
- was decreased, and serum total cholesterol, Ca
2+, uric acid, and urea nitrogen were elevated. Serum Na
+, K
+ and fasting blood sugar showed no change in either of the two groups. the cardio-thoracic ratio was decreased in elderly patients.
Side effects of tripamide were noted in 5 of 59 younger patients (8%), while elderly patients were free from side effects. When abnormal laboratory data were included in side effects, the incidence of side effects was 15% (9/59) for younger patients and 12% (4/33) for elderly patients.
The rate of usefulness for tripamide was 78.8% for elderly patients and 52.5% for younger patients, the difference between the two age groups being statistically significant (p<0.05). The results of this study seem to provide the evidence that tripamide is more beneficial for the elderly than for the younger patients in controlling essential hypertension.
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