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 the fixed combination of enalapril/diltiazem ER and their monotherapies in stage 1 to 3 essential hypertension.
The safety and efficacy of two fixed dose combinations of enalapril and diltiazem extended release formation ( ER ) ( E/D ) were compared with their monotherapies and placebo in patients with stage 1 to 3 hypertension . The trial design was a multicenter , r and omized , double blind , placebo controlled , parallel group , 12 week treatment phase , followed by a 36 week , open label phase . A total of 891 patients with sitting diastolic blood pressure ( SiDBP ) between 95 and 115 mm Hg were r and omly assigned to enalapril 5 mg , diltiazem ER 120 mg , diltiazem ER 180 mg , enalapril 5 mg/diltiazem ER 120 mg ( E5/D120 ) , enalapril 5 mg/ diltiazem ER 180 mg ( E5/D180 ) , or placebo . In the open label phase , 562 patients received the fixed combination , titrated as needed to control SiDBP < 90 mm Hg . Efficacy was determined with trough ( 24 + /- 2 h postdose ) sitting blood pressure measurements at week 12 and at the end of the open label part of the study . Safety was evaluated based on patient symptoms , clinical laboratories , and electrocardiograms ( ECG ) . E5/D120 and E5/D180 significantly reduced trough SiDBP ( -7.6 and -8.3 mm Hg , respectively ; P < .05 ) versus their monotherapies . E5/D120 and E5/D180 significantly reduced trough sitting systolic blood pressure ( -7.9 and -9.0 , respectively ; P < .05 ) versus both diltiazem ER monotherapies . All active treatments significantly decreased SiDBP and SiSBP versus placebo . E/D effectively lowered SiDBP and SiSBP during the open label extension . No significant difference was seen among treatment groups for the overall incidence of adverse events . The most common drug related adverse events were headache , edema/swelling , dizziness , asthenia/fatigue , cough , rash , and impotence . The event frequency for the combinations were similar to those seen with the monotherapies . Fixed combinations of E/D were generally well tolerated , with an increased blood pressure lowering effect as compared with the individual components in patients with stage I to III hypertension
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 .