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 .
A double-blind randomized evaluation of converting enzyme inhibition as the first-step treatment of mild to moderate hypertension.
The new angiotensin converting enzyme inhibitor , enalapril ( MK-421 ) , was tested by a double-blind trial . Patients with uncomplicated essential hypertension were r and omly allocated to one of two stepped-care treatment groups : enalapril 20 mg once-a-day , or placebo as the first step , followed when necessary by the successive addition of hydrochlorothiazide ( 25 and 50 mg ) , oxprenolol ( 160 and 320 mg ) and dihydralazine ( 50 and 100 mg ) . Blood pressure was normalized in both groups , although the enalapril group showed lower systolic and diastolic blood pressures than the placebo group ( systolic 130.5 + /- 12 versus 136.6 + /- 9 mmHg , P less than 0.01 ; diastolic 82.8 + /- 6 versus 87.0 + /- 5 mmHg , P less than 0.001 ) . These results were obtained with a smaller number of tablets per day ( 2.6 + /- 1.8 versus 4.2 + /- 2.4 mmHg , P less than 0.0001 ) . Plasma potassium was identical for both groups at the start of treatment . At the end of the study , it was significantly higher in the enalapril group than in the placebo group ( 4.1 + /- 0.3 versus 3.9 + /- 0.5 mmol/l ; P less than 0.05 ) . Spontaneous complaints were noted during the bi-weekly or monthly visit and were also expressed by patients completing a self-administered question naire . Differences in spontaneous complaints or in the symptoms evaluated by the question naire were not significant . The increase in the number of symptoms at the end of the study was greater in the placebo group than in the enalapril group , but the difference was not statistically significant . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .