The data do not suggest that any one ACE inhibitor is better or worse at lowering BP .
ACE inhibitor doses above Max did not significantly lower BP more than Max .
There are no clinical ly meaningful BP lowering differences between different ACE inhibitors .
BACKGROUND ACE inhibitors are widely prescribed for hypertension so it is essential to determine and compare their effects on blood pressure ( BP ) , heart rate and withdrawals due to adverse effects ( WDAE ) .
OBJECTIVES To quantify the dose-related systolic and /or diastolic BP lowering efficacy of ACE inhibitors versus placebo in the treatment of primary hypertension .
Dose response and safety of telmisartan in patients with mild to moderate hypertension.
This r and omized , double-blind , double-dummy , placebo-controlled , parallel-group study evaluated the dose-response relationship of telmisartan in 207 patients with mild to moderate hypertension ( diastolic blood pressure [ DBP ] 100 to 114 mmHg ) . After a 28-day placebo run-in period , patients were r and omized to 28 days of once-daily , double-blind , double-dummy treatment with telmisartan 40 , 80 , or 120 mg ; enalapril 20 mg ; or placebo .  Blood pressure ( BP ) was manually recorded for 12 hours after the first dose and after 24 hours at baseline ( Day 0 ) , Day 1 , and Day 28 of double-blind treatment . Pharmacokinetic and pharmacodynamic parameters were assessed from telmisartan plasma concentrations . All doses of telmisartan and enalapril significantly reduced BP compared with placebo ( p < or = 0.01 ) . Mean + /- SE reductions in supine DBP after 28 days of treatment ranged between 7.9 + /- 1.3 mmHg and 9.8 + /- 1.3 mmHg in the telmisartan groups , 9.6 + /- 1.3 mmHg with enalapril , and 1.5 + /- 1.3 mmHg with placebo . Mean + /- SE reductions in supine systolic blood pressure ( SBP ) were between 10.0 + /- 2.2 mmHg and 15.5 + /- 2.2 mmHg with telmisartan versus 10.2 + /- 2.1 mmHg with enalapril ; placebo increased supine SBP by 3.5 + /- 2.1 mmHg . The BP reductions after 4 weeks of treatment with telmisartan were no different from those achieved with enalapril . No significant linear trend in BP reduction was evident among telmisartan doses . Reductions in SBP and DBP were maintained over the 24-hour period at Day 28 . Treatment did not affect supine heart rate . Trough/peak DBP ratios were > or = 85 % for all telmisartan doses versus 65 % for enalapril . High interpatient variability in  telmisartan plasma concentrations was observed . For example , mean + /- SD values for Cmax were 159 + /- 104 ng/mL for telmisartan 40 mg , 693 + /- 606 ng/mL for telmisartan 80 mg , and 1635 + /- 1406 ng/mL for telmisartan 120 mg . Plasma concentration-effect analyses indicated that the antihypertensive effects of telmisartan 40 , 80 , and 120 mg are at the plateau region of the concentration-response curve . All active treatments were well tolerated , with tolerability profiles similar to placebo , and telmisartan did not produce any clinical ly relevant first-dose effects . These data confirm the antihypertensive efficacy and placebo-like tolerability of telmisartan
The data do not suggest that any one ACE inhibitor is better or worse at lowering BP .
ACE inhibitor doses above Max did not significantly lower BP more than Max .
There are no clinical ly meaningful BP lowering differences between different ACE inhibitors .
BACKGROUND ACE inhibitors are widely prescribed for hypertension so it is essential to determine and compare their effects on blood pressure ( BP ) , heart rate and withdrawals due to adverse effects ( WDAE ) .
OBJECTIVES To quantify the dose-related systolic and /or diastolic BP lowering efficacy of ACE inhibitors versus placebo in the treatment of primary hypertension .