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 .
Comparison of Efficacy of Spirapril and Enalapril in Control of Mild-to-Moderate Hypertension
The efficacy of spirapril , 6 mg once daily , was compared with enalapril , 5–20 mg once daily , in the control of mild-to-moderate hypertension in a placebo-controlled , parallel-group study . A total of 251 patients participated in the study , all of whom underwent a 4-week washout period on placebo .  Thereafter , 100 patients were r and omized to spirapril , 6 mg once daily , 101 patients to enalapril , 5–20 mg once daily , and 50 patients remained on placebo .  Sitting diastolic blood pressure ( DBP ) and systolic blood pressure ( SBP ) were measured at 2-weekly clinic visits . Blood pressure profiles during peak and trough plasma drug concentrations ( 2–4 hours and 24 hours postdose , respectively ) were determined at baseline and 4 and 8 weeks after starting the double-blind phase . Compared with placebo , treatment with both spirapril and enalapril result ed in significant reductions ( p > 0.001 ) in DBP and SBP . DBP was reduced to a greater extent with spirapril than with enalapril both at peak ( −17.4 mmHg vs. −14.8 mmHg ) and trough ( −14.7 mmHg vs. −12.4 mmHg ) . Thus , although the trough/peak DBP ratios for spirapril and enalapril were very similar ( 84 % vs. 82 % ) , actual reductions in DBP were different . Spirapril and enalapril treatment result ed in similar reductions in SBP at both peak and trough levels . Both drugs were well tolerated , and there were very few adverse events or changes in hematological or biochemical parameters during the study . In conclusion , spirapril , 6 mg once daily , as the initial and maintenance dose , is at least as effective and well tolerated as enalapril individually titrated
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 .