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 .
Lack of effect of short-term lisinopril administration on left ventricular filling dynamics in hypertensive patients with diastolic dysfunction.
Arterial hypertension may be associated with altered left ventricular filling dynamics . The specific goal of this study was to evaluate whether short-term administration of the ACE inhibitor lisinopril in hypertensive patients with an altered diastolic pattern induced an improvement of left ventricular dynamics , assessed by the echocardio-Doppler technique , independently of effects on left ventricular mass . In a double-blind cross-over study 39 essential hypertensive patients with a ratio of peak early to peak atrial velocity ( E/A ) < 1 were r and omized , after a run-in period of 2 weeks without any antihypertensive treatment , to receive lisinopril ( 20 mg once a day ) and placebo for 4 weeks , respectively . At the end of both the run-in and the treatment periods , blood pressure and heart rate were measured and an echocardio-Doppler examination was carried out . The echocardio-Doppler evaluation was performed both at rest and at the peak of a h and -grip test ( 3 min at 30 % of maximal strength ) . Left ventricular dimensions were obtained from two-dimensionally guided M-mode tracings using the criteria of the American Society of Echocardiography . Left ventricular peak filling rates and filling rate integrals were measured by a pulsed Doppler technique . Lisinopril caused a significant reduction in systolic and diastolic blood pressure at rest ( -13/-9 mmHg vs baseline values , p < 0.05 ; -6/-4 mmHg vs placebo values , p < 0.05 ) and during isometric exercise ( -17/-9 mmHg vs baseline period , p < 0.05 ; -6/-5 mmHg vs placebo , p < 0.05 ) . Lisinopril did not induce any significant change in left ventricular structure and systolic function . All the left ventricular filling parameters considered ( E velocity , A velocity , E/A ratio ) both at rest and during isometric exercise did not significantly differ after lisinopril treatment when compared to those obtained in basal conditions and after placebo administration . This double-blind cross-over study demonstrates that short-term afterload reduction induced by lisinopril does not modify altered diastolic dynamics in hypertensive patients . Diastolic dysfunction of the left ventricle is a complex process influenced by a number of functional and structural factors and apparently can not be significantly improved by short-term blood pressure reduction by antihypertensive therapy
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 .