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 .
Verapamil SR and trandolapril combination therapy in hypertension--a clinical trial of factorial design. German Hypertension Study Group.
AIMS To investigate the dose-response relationship and contribution of verapamil SR and tr and olapril given in combination once a day for the treatment of essential hypertension . METHODS A r and omized , double-blind , placebo controlled , factorial , 12 arm parallel group comparison with placebo , verapamil SR ( 120 , 180 mg ) , tr and olapril ( 0.5 , 1.0 , 2.0 mg ) covering all combinations of both drugs . A 4 week placebo run-in period followed by 6 weeks of treatment . Four hundred and fifty-six patients from office practice ( 22 centres ) with mild to moderate hypertension enrolled and 426 with diastolic pressure > or = 100 mm Hg at the end of run-in period were r and omized . Main outcome measures were reduction in sitting systolic ( SBP ) and sitting diastolic ( DBP ) blood pressure . RESULTS The combination of verapamil SR and tr and olapril , particularly verapamil SR 180 mg and tr and olapril 0.5 or 1.0 mg was significantly superior to both monocomponents at the same dose ( P<0.05 ) . For these combinations , the adjusted mean reductions in DBP from baseline to last visit were 14.1 and 16.0 mm Hg , respectively . Response surface analysis provided further evidence that these combinations were optimal for antihypertensive efficacy . All treatments were well tolerated . The incidence of adverse events did not differ significantly between treatment groups ; the profile of adverse events on combination therapy was mild and consistent with that of each monocomponent . CONCLUSIONS All dosage combinations of verapamil SR and tr and olapril produced significantly greater reduction of blood pressure than the monotherapy at the same dosage . However , verapamil SR 180 mg in combination with tr and olapril 1.0 mg was the dosage with the greatest blood pressure reduction and had the greatest effects compared with the monocomponents
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 .