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 randomised, placebo-controlled, double-blind, crossover study of losartan and enalapril in patients with essential hypertension
The primary objective of this r and omised , placebo- controlled , double-blind , crossover study , was to evaluate and compare the longer term effects of the angiotensin II type 1 receptor antagonist losartan and the converting enzyme inhibitor enalapril on 24-h ambulatory blood pressure ( BP ) . After a 4-week placebo run-in period , nine patients with essential hypertension entered the double-blind phase of the study , which consisted of three 6-week periods during which patients were treated with placebo , enalapril 20 mg o.d . or losartan 50 mg o.d . Losartan and enalapril , taken between 07.00 and 08.00 , reduced ambulatory BP throughout the 24-h period . Average night time BP was reduced from 133/85 mm Hg on placebo to 124/78 mm Hg on enalapril and to 126/77 mm Hg on losartan . Daytime BP averaged 157/101 mm Hg on placebo , and was significantly lower during enalapril ( 142/91 mm Hg ) than during losartan treatment ( 147/95 mm Hg ) . Clinic BP , measured 2 to 4 hours after drug intake , was reduced to the same extent by both drugs . The losartan-induced BP changes were significantly related to those obtained with enalapril ( 0.63 < r < 0.93 ) . Ambulatory BP monitoring was repeated after 4 weeks of combined therapy in six patients . The BP lowering effect of the combination was not significantly better than that achieved with enalapril alone . In conclusion , losartan 50 mg o.d . and enalapril 20 mg o.d . lower BP to approximately the same extent , except for a more pronounced effect of enalapril on daytime ambulatory BP . The current study does not provide convincing evidence that addition of losartan to enalapril in the doses used further reduces BP
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 .