Comparison between enalapril and lisinopril in mild-moderate hypertension: a comprehensive model for evaluation of drug efficacy.
The objective of this study was to compare enalapril with lisinopril in terms of blood pressure control at rest, during dynamic exercise test, during isometric exercise test, and during 24 h--with special focus on blood pressure control during the morning hours, 18-24 h post-dose. Furthermore, we compared ACE activity in serum before and after 4 weeks of drug treatment. A four-week double-blind, randomized parallel group study compared enalapril 20 mg o.d. with lisinopril 20 mg o.d. preceded by a 4-week single blind run-in period on placebo. Fifty-eight patients (49 males and 9 females, mean age 50.9) were recruited and 56 completed the study. Blood pressures at randomization were 161/108 and 164/106 for the enalapril and the lisinopril subjects, respectively. Echo: LVPWd 9.5 (normal range 6-12 mm) and IVSd 10.3 mm (normal range 6-12 mm).


METHODS
ANCOVA. Enalapril and lisinopril were equally effective in lowering blood pressure at rest, during dynamic and isometric exercise as well as during 24 h. The attained blood pressure levels during the early morning hours were for enalapril treatment 119/76 and 121/76 mmHg for lisinopril treatment. The ACE activity in serum 24 h post-dose was lower (p < 0.001) after treatment with lisinopril 8.0 (SD 3.3) mumol/min/1 than with enalapril 16.1 (SD 6.0). The corresponding values for placebo were 18.8 (SD 4.6) and 17.8 (SD 5.7). No difference was found in blood pressure lowering efficacy between enalapril and lisinopril even though the blood pressure changes were evaluated in a more comprehensive way than in earlier studies of these drugs.(ABSTRACT TRUNCATED AT 250 WORDS)
Enström
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Health Sciences Centre, Dalby, Sweden.
Thulin
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Lindholm
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LH
D000328:Adult; D004311:Double-Blind Method; D004656:Enalapril / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017706:Lisinopril / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000097:blood
D004656:Enalapril; D017706:Lisinopril; D007703:Peptidyl-Dipeptidase A