Placebo-controlled comparison of the efficacy and tolerability of once-daily moxonidine and enalapril in mild-to-moderate essential hypertension.
OBJECTIVE
To compare the antihypertensive efficacy and tolerability of the imidazoline I1 receptor agonist moxonidine, a centrally acting antihypertensive, with the angiotensin converting enzyme inhibitor enalapril.


METHODS
An 8-week, double-blind, randomized, placebo-controlled study involving 140 outpatients with mild-to-moderate essential hypertension.


METHODS
Outpatients with WHO stage I or II hypertension were enrolled in the study. After a 4-week placebo-controlled stabilization phase patients were allocated randomly to placebo, 0.2 mg moxonidine once a day or 5 mg enalapril once a day for 2 weeks. Dosages were then doubled to 0.4 mg moxonidine once a day or 10 mg enalapril once a day for a further 6 weeks. Blood pressure responses to therapy were measured by conventional office techniques and by 24 h ambulatory blood pressure monitoring.


RESULTS
The mean reduction in sitting blood pressure with moxonidine was similar to that with enalapril (19.5 +/- 16.0/12.3 +/- 8.7 versus 18.9 +/- 13.7/11.8 +/- 8.0 mmHg) and significantly superior to that with placebo (-4.6 +/- 12.3/-4.7 +/- 6.8 mmHg, P< 0.001). In addition to reducing blood pressure during conventional measurements, moxonidine administration reduced blood pressure throughout 24 h ambulatory measurements. The trough:peak ratio for moxonidine was 0.7. Both moxonidine and enalapril were tolerated well.


CONCLUSIONS
Moxonidine is an effective and well-tolerated antihypertensive, at least as good as other established forms of antihypertensive medication. The trough:peak ratio of 0.7 indicates that the drug will be effective administered once a day.
Küppers
H E
HE
Solvay Pharmaceuticals, Hannover, Germany.
Jäger
B A
BA
Luszick
J H
JH
Gräve
M A
MA
Hughes
P R
PR
Kaan
E C
EC
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004361:Drug Tolerance; D004656:Enalapril / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007093:Imidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D054755:Imidazoline Receptors; D008297:Male; D008875:Middle Aged; D011955:Receptors, Drug / Q000819:agonists
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D007093:Imidazoles; D054755:Imidazoline Receptors; D011955:Receptors, Drug; D004656:Enalapril; C043482:moxonidine