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 .
Comparison of candesartan versus enalapril in essential hypertension. Italian Candesartan Study Group.
BACKGROUND The objective of this study was to compare the antihypertensive efficacy and tolerability of c and esartan cilexetil ( CC ) with that of enalapril ( E ) and placebo ( P ) in hypertensives by clinic and ambulatory blood pressure ( BP ) .  PROCEDURES The study was an Italian multicenter , r and omized , double-blind , parallel group trial including 227 mild to moderate essential hypertensives ( age range , 18 to 70 years ) . After 4 weeks of P , patients were r and omized to 8 weeks of treatment with P or CC ( 4 mg ) or E ( 10 mg ) once daily , which was eventually increased to 8 mg and 20 mg once daily in nonresponders . At the end of each study phase , trough BP was measured by conventional sphygmomanometry and ambulatory BP was monitored over 24 h by a Spacelabs device . Analysis of 24-h BP profile included calculation of 24-h , daytime , nighttime , and hourly average values . RESULTS In the 178 patients evaluable per protocol , at the end of 8 weeks of treatment , trough systolic ( S ) and diastolic ( D ) BP were similarly reduced by both active treatments ( 13 + /- 12 and 10 + /- 7 mm Hg for CC and 14 + /- 12 and 10 + /- 7 mm Hg for E ) and significantly more by both treatments than by P ( 6 + /- 11 and 7 + /- 8 mm Hg , P < .01 v CC and E ) . In the 85 patients with valid 24-h recordings reduction in 24-h BP was again similar for the two active groups . The antihypertensive effect was still evident during h 23 and 24 after the last dose for both active treatments ( 8 + /- 20 v 5 + /- 18 mm Hg for SBP and 4 + /- 12 v 6 + /- 13 mm Hg for DBP , CC v E , respectively ) but not for P. Heart rate was not significantly modified by either active treatment . The incidence of adverse events was greater in the E than in the CC group . CONCLUSIONS Our study provides evidence that CC at a dose of 4 to 8 mg is as effective as E at a dose of 10 to 20 mg over 24 h , but is better tolerated than
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 .