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 .
Captopril and Nifedipine Interactions in the Treatment of Essential Hypertensives: A Crossover Study
In order to evaluate the antihypertensive effect and the tolerability of combination therapy with an angiotensin converting enzyme inhibitor ( captopril ) and a dihydropyridine calcium antagonist ( nifedipine ) compared with monotherapy and placebo , we studied 32 uncomplicated essential hypertensives . At the end of a 1-month placebo washout period , their diastolic blood pressure was > 105 and < 120mmHg . The subjects then received , according to a double-blind r and omized crossover design , captopril ( 50 mg twice daily ) , nifedipine ( 20 mg twice daily ) , captopril plus nifedipine at the same doses and the corresponding placebo , each treatment being given for 1 month . Both captopril and nifedipine significantly reduced mean blood pressure , which was further and significantly reduced by the combination of the two drugs . The decreases in mean blood pressure induced by nifedipine were significantly greater than those induced by captopril , and those induced by the combined therapy were significantly greater than those induced by either drug on monotherapy . The heart rate was significantly increased only by nifedipine , and to a similar , but not significant , extent by the combination therapy . Plasma renin activity was similarly and significantly increased and urinary aldosterone tended to decrease to a similar extent under the three active treatments . Adverse effects were mild to moderate in intensity ; their incidence under captopril was lower than that under placebo , while the incidence under nifedipine and combined therapy was greater than under placebo .  Ankle oedema disappeared under the combined therapy in three out of four patients who developed this side effect under nifedipine , although one additional patient developed ankle oedema under combination therapy . These data indicate that : ( 1 ) captopril and nifedipine are effective antihypertensive drugs with a balanced cost-benefit ratio , since even if nifedipine alone was more effective in reducing blood pressure , it was less well tolerated than captopril ; ( 2 ) the combination of captopril and nifedipine exerted an additive antihypertensive effect without aggravating , and possibly even reducing , the incidence of adverse effects due to nifedipine . These findings confirm that the association of an angiotensin converting enzyme inhibitor with a dihydropyridine calcium antagonist can be useful in the treatment of essential hypertension
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 .