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 .
Antihypertensive Efficacy of Cilazapril 2.5 and 5.0 mg Once‐Daily Versus Placebo on Office Blood Pressure and 24‐Hour Blood Pressure Profile
Summary In a double-blind , r and omized , multicenter study the antihypertensive efficacy of cilazapril 5.0 and 2.5 mg once daily vs. placebo was examined on 180 ambulatory hypertensive subjects with supine diastolic office blood pressure ( OBP ) 3 ≥ 95 and ≤ 115 mm Hg : a 4-week , single-blind , placebo period was followed by a 4-week double-blind treatment period . At the beginning and end of the latter , OBP measurements and ambulatory 24-h BP monitoring ( ABPM ) were both carried out on two different days ( 3 ± 1 ) , whereby each time two 24-h BP recordings were made using SpaceLabs 90202 . Measurements were made every 30 min , and actual waking and sleeping phase evaluation was done using diary entries . White coat hypertensive patients were excluded by the ambulatory BP ( ABP ) inclusion criterion : mean diastolic 24-h BP ≥ 85 mm Hg , or frequency of measurements > 90 mm Hg 5 ≥ 35 % . One-hundred eighty patients were included in the study . Safety was evaluated in 170 of these patients , and efficacy on OBP in 162 . Twenty-four-hour BP recordings that were amenable to analysis were available in the case of 146 patients ( average age 56 ± 10 years , 56 women , 90 men ) . The results of the main target variable for OBP , namely responder rates , were in the three treatment groups : placebo , 39.6 % ; cilazapril 2.5 mg , 55.6 % ; and cilazapril 5.0 mg , 65.5 % . All three treatment groups revealed a statistically significant effect ( p < 0.001 ) on the reduction of mean BP values : placebo from 161.6/102.2 to 149.4/94.7 mm Hg , cilazapril 2.5 mg from 162.9/102.1 to 149.7/92.0 mm Hg , and cilazapril 5.0 mg from 158.4/100.6 to 145.6/90.5 mm Hg . In contrast to OBP data , the analysis of the 24-h ABP profile showed a significant global antihypertensive effect on systolic and diastolic mean values only in the case of the two cilazapril dosages ( p < 0.001 ) . The drop in 24-h mean values was as follows : placebo from 148.3/91.7 to 146.1/90.1 , cilazapril 2.5 mg from 151.0/93.3 to 143.6/88.9 , cilazapril 5.0 mg from 148.0/92.2 to 140.8/86.1 . Analysis of the placebo effect using OBP measurement and ABPM led to completely opposing conclusions . In OBP measurement , a highly significant antihypertensive 24-h trough effect is simulated . In 24-h BP , the placebo effect is slight and restricted to a limited time interval ( approximately 8 h ) during the active waking phase . Both cilazapril groups had equipotent antihypertensive effects on systolic BP but distinctly dose dependent effects on diastolic BP . Both dosages demonstrated a continuous BP control , especially during the critical early morning waking-getting-up phase . Cilazapril 2.5 and 5.0 mg once daily was well tolerated
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 .