[A comparative study of the efficacy of lisinopril versus quinapril in controlling light to moderate arterial hypertension. A follow-up with ABPM].
OBJECTIVE
To compare the antihypertensive efficacy of lisinopril versus quinapril given 20 mg once daily for the treatment of mild to moderate arterial hypertension (I-II WHO grades) using ambulatory blood pressure monitoring. This study also investigated the tolerance, adverse effects and changes in haematological or biochemical parameters with both drugs.


METHODS
Fifty patients (men and women) with a range of age between 18 to 75 years were included in this open, randomized study to assess the hypotensive efficacy of lisinopril versus quinapril after 2 months of treatment, using ambulatory blood pressure monitoring (ABPM). To study data obtained from ABPM Mc Call curves were used and statistical analysis was made using Epistat programme. Covariance and Chi-square test were used for the comparative analysis of different variables, considering as statistically significant the value p < 0.05. Graphics were made using Lotus 123, V 3.0 version. All patients gave their informed consent to participate in the study. The protocol was approved by the Ethical Committee of the Clínico Hospital.


RESULTS
Systolic blood pressure decreased from 172.6 to 152.6 mmHg in the lisinopril group (p < 0.001) and from 171.6 to 147 mmHg in the quinapril group (p < 0.001). Diastolic blood pressure decreased from 105.6 to 86.8 mmHg in the lisinopril group (p < 0.001) and from 106.1 to 88.1 mmHg in the quinapril group (p < 0.05). Using ABPM mean systolic blood pressure decreased from 157.3 to 126.5 mmHg with lisinopril (p < 0.001) and from 148 to 137.4 mmHg with quinapril (p < 0.05). Mean diastolic blood pressure decreased from 93.6 to 81.7 mmHg with lisinopril (p < 0.001) and from 89.4 to 85.9 with quinapril (p < 0.05). Decreases in basal glycemia were found from 0.996 to 0.878 in quinapril group (p < 0.05), total quinapril cholesterol in both groups (from 228.7 to 207.2 with lisinopril and from 247.4 to 225.7 with quinapril) (p < 0.05) and cholesterol-LDL in the quinapril group (180.1 to 152.1) (p < 0.05).


CONCLUSIONS
Both drugs produce a fall of blood pressure in mild-to-moderate hypertension, although using ABPM this fall is more significant with Lisinopril. According to Mc Call index 73.4% of patients in the lisinopril group and 62.7% of quinapril group controlled their hypertension, and a difference found between BP values obtained in the clinic and those obtained using ABPM.
Motero Carrasco
J
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Centro Periférico de Especialidades Virgen de la Cinta, Huelva.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007546:Isoquinolines / Q000627:therapeutic use*; D017706:Lisinopril / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000077583:Quinapril; D044005:Tetrahydroisoquinolines; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D007546:Isoquinolines; D044005:Tetrahydroisoquinolines; D017706:Lisinopril; D000077583:Quinapril
Estudio comparativo de la eficacia de lisinopril versus quinapril en el control de la hipertensión arterial leve-moderada. Seguimiento con ABPM.