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 .
Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension: efficacy, tolerability and safety compared to an angiotensin-converting enzyme inhibitor, lisinopril
Objective : To compare the efficacy , safety and tolerability of valsartan to an angiotensin-converting enzyme ( ACE ) inhibitor , lisinopril , and placebo in patients with mild-to-moderate essential hypertension . Design : A total of 734 men and women were r and omised in this multicentre , double-blind , optional titration , parallel group trial . Volunteers received valsartan 80 mg ( n = 364 ) , lisinopril 10 mg ( n = 187 ) or placebo ( n = 183 ) daily for 4 weeks , with subsequent titration of dose depending on response to treatment ( valsartan 80 mg titrated to valsartan 160 mg once daily or valsartan 80 mg twice daily , lisinopril 10 mg titrated to lisonopril 20 mg once daily ) . Patients were assessed at 4 , 8 and 12 weeks . Main outcome measures : The primary variable was change from baseline in mean sitting diastolic blood pressure ( SDBP ) . Other efficacy variables included sitting systolic blood pressure ( SSBP ) and percentage of ‘ successful ’ responders ( SDBP < 90 mm hg or ⩾10 mm hg reduction from baseline ) . Results : All active treatment groups were shown to demonstrate significant reductions in SDBP compared to placebo at endpoint of therapy ( least mean square reduction from baseline : valsartan 80/160 mg : −5.25 mm Hg ( CI −7.17 , −3.34 , P < 0.001 ) ; valsartan 80/80 mg twice daily : −5.63 mm hg ( ci −7.51,−3.75 , P < 0.001 ) ; lisinopril 10/20 mg : −6.93 mm hg , ( ci −8.81 , −5.05 , P < 0.001 ) . there were no statistically significant differences between the active treatment groups at endpoint of therapy . in patients requiring titration to a higher dose ( placebo n = 142 , valsartan 80/80 twice daily n = 124 , valsartan 80/160 n = 114 , lisinopril 10/20 n = 120 ) , there were no significant treatment differences between valsartan 160 mg given as a single daily dose or as 80 mg twice daily ( P = 0.658 ) . Both valsartan and lisinopril produced similarly high percentages of ‘ successful ’ responders at endpoint of therapy . A somewhat higher frequency of drug related cough was observed in lisinopril treated patients ( 8 % ) compared to valsartan ( 1.1 % ) or placebo ( 0.5 % ) . Conclusions : Valsartan 80 mg daily , with titration to 160 mg daily as required , provides similar antihypertensive efficacy to lisinopril 10 mg daily with titration to 20 mg daily . Valsartan provides a new antihypertensive agent with comparable efficacy to lisinopril and appears to be associated with a reduced incidence of cough
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 .