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 .
Differing mechanisms of action of angiotensin-converting enzyme inhibition in black and white hypertensive patients. The Trandolapril Multicenter Study Group.
The antihypertensive effect of the angiotensin-converting enzyme inhibitor tr and olapril administered in doses of 1 , 2 , and 4 mg/d was compared in 207 white patients and 91 black patients with mild to moderate hypertension following a double-blind , r and omized , placebo-controlled , parallel study design . Tr and olapril is a prodrug that is rapidly hydrolyzed to its active diacid metabolite , tr and olaprilat . After 6 weeks of double-blind treatment , tr and olapril lowered baseline sitting diastolic pressure in both white and black patients . A comparison of the antihypertensive response of the two population s revealed that the black patients required between two and four times the dose of tr and olapril to obtain a response similar to that observed in the white patients . A dose of 1 mg/d tr and olapril result ed in a 6.1 mm Hg mean decrease in baseline sitting diastolic pressure for white patients ; a similar response ( -6.5 mm Hg ) was observed in the black patients at 4 mg/d . In contrast to the population differences in blood pressure , the decreases in angiotensin-converting enzyme activity were similar for both population s. An evaluation of tr and olaprilat levels revealed that there were no racial differences in the tr and olaprilat concentrations required to achieve a given degree of angiotensin-converting enzyme inhibition . Therefore , it appears that the antihypertensive response of black patients is not completely explained by a reduction in angiotensin-converting enzyme activity . The lack of response at a lower dose but increasing response at a higher dose could reflect another vasodepressor activity of tr and olapril or just be evidence of reduced sensitivity of high blood pressure in blacks to angiotensin-converting enzyme inhibition
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 .