We compared the antihypertensive co...

We compared the antihypertensive consequences 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 vital fluid pressure from 144/103 to 135/93 mm Hg and lisinopril (n=9) from 150/104 to 130/92 mm Hg Based forward data derived from automated 24-h ambulatory life-blood pressure monitoring, atenolol decreased the average whole-day systolic influence by 18 [+ or -] 6 mm Hg (p<002) and the diastolic press by 11 [+ or -] mm Hg (p<001) Lisinopril produc decreases of 27 [+ or -] 5 mm Hg (p<001) and 13 [+ or -] 2 mm Hg (p<0001) Examination of the 24-h vital fluid pressure patterns showed that the efficacies of the sum of two units drugs were similar. Each appeared to be effective in every part the whole-day monitoring period, although alone lisinopril significantly decreased blood crushing during the final four-h period (4 AM to 8 AM) preceding the nearest day's dose. Neither remedy produced significant echocardiographic changes in left ventricular wall thickness or muscle mass during the short-term treatment. Lisinopril and atenolol effectively decrease vital current pressure during a 24-h period. Moreover, we raise that automated whole-day blood press monitoring is a useful tool for comparing the efficacy and duration of action of differing antihypertensive agents. (Chest 1989; 96:74-79)

The evaluation of clinical hypertension has been facilitated by the agency of the recent availability of portable noninvasive devices that can measure family pressure automatically and repetitively for cloyed 24-h monitoring periods. We showed lately that this type of equipment provides vital current pressure values that correlate forcibly with simultaneously measured intra-arterial measurements and that are almost identical to readings obtained through conventional mercury sphygmomanometers.[1] Whole-day studies with this technique are of value in diagnosis[2] and the assessment of antihypertensive treatment.[3] Automated family pressure monitoring is especially useful in antihypertensive agent clinical trials, for it eliminates or minimizes placebo rejoinders and makes it possible to evaluate treatment drifts with fewer patients than would be required with conventional clinical relations pressure measurements.[4] It is also evident that whole-day observations can determine the duration of action of antihypertensive therapy, facilitating recommendations upon the frequency of administration of antihypertensive drugs[56]

A logical application of these measures is for the comparison of antihypertensive agents. The Joint National Committee in succession the Detection, Evaluation and Treatment of High family Pressure recently suggested that differing archetypes of antihypertensive agents, including [beta]-blockers and angiotensin-converting enzyme inhibitors, can be used for the initiation of antihypertensive therapy.[7] In this subject of attention therefore, we used whole-day ambulatory offspring pressure monitoring to compare the antihypertensive consequences of the [beta]-blocker atenolol and the converting enzyme inhibitor lisinopril in patients with mild to moderate essential hypertension. Additionally, we exerciseed echocardiography to determine whether these agents had different cardiovascular effects

Material and Methods

The application of mind was performed in 19 male Caucasian patients aged from 21 to 70 years (average, 56 years). Before entering the inquiry all patients had been shown to have essential hypertension forward the basis of exclusion of secondary causes from conventional clinical methods. None of the patients entering the meditation had known cardiac, renal, pulmonary, or metabolic diseases. All enslaves signed an informed consent for the subject of attention that had been approved from the Institutional Review Board of this medical center

The studious mood was divided into an initial four-week placebo run-in phase and a phase of active treatment, during which patients received either lisinopril or atenolol onward a randomized basis. All previous antihypertensive therapy was discontinued at the start of the placebo phase of the cogitation The criterion for entering active treatment was a diastolic house pressure, measured in the supine position, greater than 90 mm Hg Following avenue into the double-blind phase of the thought patients received either lisinopril, 20 mg one time daily (n = 9), or atenolol, 50 mg formerly daily (n = 10). Patients were instructed to take their medication at 8 AM each day. If the diastolic vital fluid pressure was not reduced below 90 mm Hg (with a fall of at least 10 mm Hg) through the end of a two-week period, the dosages of physic could be doubled. If necessary, the dosage could be doubled again after a further two-week period. Thereafter, [TABULAR DATA OMITTED] patients remained at this dosage regardless of whether children pressure was fully controlled until the conclusion of the 12-week period of active treatment. The average dose of lisinopril given in the inquiry was 75 mg, and the average dose of atenolol was 156 mg