[Efficacy of enalapril combined with folic acid in lowering blood pressure and plasma homocysteine level].
OBJECTIVE
To investigate the efficacy of enalapril combined with folic acid in lowering both blood pressure and plasma total homocysteine (Hcy) in essential hypertensive patients.


METHODS
A randomized, community-based clinical trial was conducted. Subjects with hypertension were randomly assigned to one of three treatment groups:enalapril 10 mg/d alone (control), enalapril 10 mg plus folic acid 0.4 mg daily (low-dose group) and enalapril 10 mg combined with folic acid 0.8 mg daily (high-dose group) for a total of 8 weeks. Resting blood pressures of all subjects was measured at baseline, 2nd, 4th, 6th and 8th week of therapy. Plasma Hcy levels were measured at baseline, 4 week and the end of study.


RESULTS
A total of 273 hypertensive patients were enrolled. All analyses were performed according to the intention to treat. Compared with control group, both low- and high-dose group had significantly a greater efficacy in lowering both blood pressure and plasma Hcy level, or in lowering either blood pressure or plasma Hcy level, or in lowering Hcy level. The proportion of subjects showing a marked reduction in both blood pressure and plasma homocysteine in control group, low-dose group and high-dose group were 3.8%, 15.2% and 17.1% respectively; the proportion of subjects showing a marked reduction in either blood pressure or plasma homocysteine in control group, low-dose group and high-dose group were 43.8%, 70.9% and 58.5% respectively. Effect upon blood pressure lowering was not significantly different among these three regimens.


CONCLUSIONS
As compared to enalapril alone, enalapril combined with folic acid showed a better efficacy in reducing both blood pressure and plasma Hcy level in hypertensive subjects.
Fu
Jia
J
First Affiliated Hospital of Anhui Medical University, Hefei 230022, China. ayfyfujia@yahoo.com.cn
Tang
Hai-Qin
HQ
Qin
Xian-Hui
XH
Mao
Guang-Yun
GY
Tang
Gen-Fu
GF
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D004305:Dose-Response Relationship, Drug; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use*; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007022:Hypotension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D006710:Homocysteine; D004656:Enalapril; D005492:Folic Acid