[Ambulatory monitoring of arterial pressure in the treatment of mild-moderate arterial hypertension with lisinopril vs. enalapril].
OBJECTIVE
To compare the antihypertensive efficacy of lisinopril (L) versus enalapril (E) given 20 mg once daily for the treatment of mild to moderate arterial hypertension (diastolic blood pressure between 90-114 mm Hg) using ambulatory blood pressure monitoring (ABPM). This study also investigated the tolerance and changes in haematological or biochemical parameters with both drugs.


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


RESULTS
Systolic blood pressure (SBP) decreased from 179.00 to 156.96 mm Hg in the Lisinopril group (p < 0.001) and from 176.65 to 149.20 mm Hg in the Enalapril group (p < 0.001). Diastolic blood pressure (DBP) decreased from 104.96 to 89.94 mm Hg in the L group (p < 0.001) and from 104.16 to 86.20 mm Hg in the E group (p < 0.001). Using ABPM mean SBP daily decreased from 163.86 to 132.26 mm Hg with L (p < 0.001) and from 156.65 to 136.18 mm Hg with E (p < 0.001). Mean DBP daily decreased from 99.23 to 87.51 mm Hg with L (p < 0.001) and from 96.55 to 87.24 with E (p < 0.001). Decreases were found from total cholesterol in both groups (from 218.46 to 207.29 mg/dl with L and from 220.59 to 205.19 mg/dl with E) (p < 0.05) and Cholesterol-LDL in the E group (150.44 to 138.88) (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. According to McCall index 73.45% of patients in the Lisinopril group and 69.26% of Enalapril group controlled their hypertension, there was a difference found between BP values obtained in the clinic and those obtained using ABPM.
Motero Carrasco
J
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Del Centro Periférico de Especialidades Virgen de la Cinta, Huelva, España.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002784:Cholesterol / Q000097:blood; D004656:Enalapril / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D017706:Lisinopril / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D002784:Cholesterol; D017706:Lisinopril