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 .
Indomethacin does not attenuate the hypotensive effect of trandolapril.
This is a r and omised , double-blind , placebo-controlled , four-way crossover study to determine if indomethacin attenuates the hypotensive effect of tr and olapril .  Twenty-three hypertensive patients ( diastolic blood pressure ( DBP ) 95 - 115 ) requiring NSAID were recruited . Seventeen completed the study . Three week treatment periods : tr and olapril 2 mg od and indomethacin 25 mg tds , tr and olapril 2 mg and placebo , indomethacin and placebo , placebo and placebo .  Clinic and ambulatory BP after 3 weeks of each treatment . Study had 85 % power to detect a 5 mm Hg difference in BP ( s.d . 7 mm Hg ) . End of treatment clinic BPs were : 152.9/98 mm Hg ( 95 % CI 147.2 , 158.6/95.8 , 101.4 ) with placebo and placebo ; 150.4/94.9 mm Hg ( 95 % CI 144.7 , 156.1/92.1 , 97.7 ) with tr and olapril and indomethacin ; 148.2/96.5 mm Hg ( 95 % CI 142.5 , 153.9/93.7 , 99.3 ) with tr and olapril and placebo ; and 156.6/97.4 mm Hg ( 95 % CI 150.9 , 162.3/94.6 , 100.2 ) with indomethacin and placebo . There were no significant interactions between tr and olapril and indomethacin for clinic systolic BP ( SBP ) ( P = 0.79 ) or clinic DBP ( P = 0.87 ) . When tr and olapril treatments ( placebo or with indomethacin ) were compared to treatments without tr and olapril ( placebo or indomethacin ) , tr and olapril lowered clinic SBP by 5.4 mm Hg ( P = 0.047 ) and DBP by 2.3 mm Hg ( P = 0.08 ) . Mean ambulatory BP was : 140.6/88.2 mm Hg ( tr and olapril and placebo ) ; 142.8/89.7 mm Hg ( tr and olapril and indomethacin ) ; 149.6/95.0 mm Hg , ( indomethacin and placebo ) ; 147.7/94.0 mm Hg ( placebo and placebo ) . Compared with placebo , tr and olapril and placebo lowered BP by 6.5/7.5 mm Hg ( P < 0.001 , SBP ; P < 0.001 , DBP ) . Compared with indomethacin , tr and olapril and indomethacin lowered BP by 5.0/5.5 mm Hg ( P = 0.001 , SBP ; P < 0.001 , DBP ) . In the present study tr and olapril 2 mg lowered clinic SBP and ambulatory BP , but indomethacin did not attenuate this . Indomethacin had no significant effect on either clinic or ambulatory BP . The antihypertensive effects of tr and olapril in this study were modest . Patient selection factors may have contributed to the observed responses , but it seems unlikely from these data that a clinical ly important drug interaction has occurred
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 .