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 .
Felodipine-metoprolol combination tablet: a valuable option to initiate antihypertensive therapy?
The aim of the present study was to assess the efficacy and tolerability of a calcium antagonist/beta-blocker fixed combination tablet used as first-line antihypertesnive therapy in comparison with an angiotensin converting enzyme inhibitor and placebo .  Patients with uncomplicated essential hypertension ( diastolic blood pressure between 95 and 110 mm Hg at the end of a 4-week run-in period ) were r and omly allocated to a double-blind , 12-week treatment with either a combination tablet of felodipine and metoprolol ( Logimax ) , 5/50 mg daily ( n = 321 ) , enalapril , 10 mg daily ( n = 321 ) , or placebo ( n = 304 ) , with the possibility of doubling the dose after 4 or 8 weeks of treatment if needed ( diastolic blood pressure remaining > 90 mm Hg ) . The combined felodipine-metoprolol treatment controlled blood pressure ( diastolic < or = 90 mm Hg 24 h after dose ) in 72 % of patients after 12 weeks , as compared with 49 % for enalapril and 30 % for placebo . A dose adjustment was required in 38 % of patients receiving the combination , in 63 % of patients allocated to placebo , and 61 % of enalapril-treated patients . The overall incidence of adverse events was 54.5 % during felodipine-metoprolol treatment ; the corresponding values for enalapril and placebo were 51.7 % and 47.4 % , respectively . Withdrawal of treatment due to adverse events occurred in 18 patients treated with the combination , in 10 patients on enalapril , and 12 patients on placebo .  No significant change in patients ' well-being was observed in either of the three study groups . These results show that a fixed combination tablet of felodipine and metoprolol allows to normalize blood pressure in a substantially larger fraction of patients than enalapril given alone . This improved efficacy is obtained without impairing the tolerability . The fixed-dose combination of felodipine and metoprolol , therefore , may become a valuable option to initiate antihypertensive treatment
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 .