Comparison of antihypertensive therapies by noninvasive techniques.
We compared the antihypertensive effects of the beta-blocker atenolol and the converting enzyme inhibitor lisinopril during 12 weeks of treatment in patients with mild to moderate essential hypertension. Atenolol (n = 10) significantly decreased conventionally measured blood pressure from 144/103 to 135/93 mm Hg and lisinopril (n = 9) from 150/104 to 130/92 mm Hg. Based on data derived from automated 24-h ambulatory blood pressure monitoring, atenolol decreased the average whole-day systolic pressure by 18 +/- 6 mm Hg (p less than 0.02) and the diastolic pressure by 11 +/- 2 mm Hg (p less than 0.01). Lisinopril produced decreases of 27 +/- 5 mm Hg (p less than 0.01) and 13 +/- 2 mm Hg (p less than 0.001). Examination of the 24-h blood pressure patterns showed that the efficacies of the two drugs were similar. Each appeared to be effective throughout the whole-day monitoring period, although only lisinopril significantly decreased blood pressure during the final four-h period (4 AM to 8 AM) preceding the next day's dose. Neither drug produced significant echocardiographic changes in left ventricular wall thickness or muscle mass during the short-term treatment. Lisinopril and atenolol effectively decrease blood pressure during a 24-h period. Moreover, we found that automated whole-day blood pressure monitoring is a useful tool for comparing the efficacy and duration of action of differing antihypertensive agents.
Graettinger
W F
WF
Hypertension Center, Veterans Administration Medical Center, Long Beach, California 90822.
Lipson
J L
JL
Klein
R C
RC
Cheung
D G
DG
Weber
M A
MA
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use*; D001795:Blood Pressure Determination; D004452:Echocardiography; D004656:Enalapril / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017706:Lisinopril; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D001262:Atenolol; D004656:Enalapril; D017706:Lisinopril