Lisinopril versus slow-release nifedipine in the treatment of mild to moderate hypertension: a multicentre study. The Cooperative Study Group.

Hôpital Tenon, Paris, France.
Journal of Human Hypertension (Impact Factor: 2.69). 07/1989; 3 Suppl 1:29-33.
Source: PubMed

ABSTRACT The antihypertensive effects of lisinopril 20 mg once daily and slow-release nifedipine 20 mg twice daily were compared in a double-blind, parallel group, 10-week study involving 274 patients with mild to moderate hypertension. During the first 6 weeks of treatment, slow-release nifedipine and lisinopril produced similar reductions in lying and standing blood pressure (BP), except for lying systolic BP (SBP) which was reduced to a greater extent by lisinopril. After 6 weeks of double-blind treatment, hydrochlorothiazide 25 mg once daily was added if BP remained uncontrolled (lying DBP greater than or equal to 95 mmHg); a significantly greater proportion of patients in the nifedipine group than in the lisinopril group required additional diuretic treatment (29% versus 14%, respectively; P = 0.005). Moreover, after a further 4 weeks of treatment BP was adequately controlled (lying DBP less than 95 mmHg) in significantly more lisinopril-treated patients than in the nifedipine group (91.4% versus 78.3%, respectively; P = 0.006). Lisinopril was better tolerated than slow-release nifedipine. The frequency of drug-related events was significantly lower (threefold) for lisinopril than for nifedipine (P = 0.001) and the number of withdrawals from treatment with nifedipine was more than three times that in the lisinopril treatment group (P = 0.009). Lisinopril appears to provide an effective once-daily antihypertensive treatment which is at least as effective as, and better tolerated than, slow-release nifedipine.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The effects of the angiotensin-converting enzyme lisinopril were compared with those of the calcium antagonist nifedipine in 162 non-insulin-dependent diabetic hypertensive patients for a 24-week period. In 83 and 79 patients, respectively, lisinopril and slow-release nifedipine produced similar reductions in blood pressure (systolic/diastolic: –16/–13 mmHg supine and –14/–11 mmHg standing after lisinopril; –15/–12 mmHg supine and –14/–11 mmHg standing after nifedipine). Fasting and post-prandial plasma glucose, glycosylated haemoglobin and plasma lipids appeared to be unaffected by either agent. Also, 28% of the patients on lisinopril and 30% of those on nifedipine presented microalbuminuria. Both drugs induced a reduction in the albumin excretion rate (AER). The geometric meanxx: tolerance factor of the reduction in AER among the 23 microalbuminuric patients on lisinopril (–10.0xx:1.3 g/min) was greater, though not significantly so, than that observed in the 26 on nifedipine (–0.9x:1.2 g/min). Moreover, lisinopril appeared to be better tolerated than nifedipine in our study population. Microalbuminuria is an important risk factor for cardiovascular mortality in non-insulin-dependent diabetic patients as well as in the general population. To what extent a reduction in the AER could ameliorate the cardiovascular prognosis in non-insulin-dependent diabetic patients is, at present, unknown. Finally, both lisinopril and nifedipine showed a similar antihypertensive effect in these patients which was not associated with significant differences in plasma glucose, insulin or lipid concentrations. The clinical consequences of the insignificant differences in AER remain unclear.
    Acta Diabetologica 01/1995; 32(3):203-208. DOI:10.1007/BF00838494 · 3.68 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Lisinopril has been compared with slow-release nifedipine in a 16-week double-blind, randomized, parallel-group study involving 102 patients with mild to moderate hypertension. Sitting systolic and diastolic blood pressures were reduced 6 and 5 mm Hg more by lisinopril than by nifedipine over 12 weeks monotherapy.
    European Journal of Clinical Pharmacology 07/1994; 46(6):487-489. DOI:10.1007/BF00196102 · 2.70 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This double-blind, randomized, multicenter study was designed to compare the efficacy and tolerability of lisinopril and hydrochlorothiazide (HCTZ) in elderly patients (≥65 years old) with either mild-to-moderate systolic/diastolic hypertension (SDBP ≥ 95 ≤ 120 mmHg) or isolated systolic hypertension (SSBP > 160 mmHg, SDBP < 90 mmHg) and creatinine clearance levels ≥ 30 ml/min. At the end of a 2-week placebo run-in period, 96 patients were randomized in a 1:1 mode to receive either lisinopril 10 mg/day or HCTZ 12.5 mg/day. During the 12-week study, the doses of lisinopril and HCTZ were doubled every 4 weeks for nonresponders to a maximum of 40 and 50 mg/day, respectively. A positive response was defined as sitting diastolic blood pressure ≤ 90 mmHg for systolic/diastolic hypertension and as sitting systolic blood pressure ≤ 140 mmHg for isolated systolic hypertension. Mean decreases from baseline in systolic and diastolic blood pressures were significant (P ≤ 0.01) in both treatment groups. Both drugs were generally well tolerated; however, patients treated with HCTZ experienced more adverse effects. Moreover, mean serum potassium levels decreased significantly in the HCTZ group. No serious adverse events were reported in either group. Lisinopril has been shown to be an effective, well-tolerated angiotensin-converting enzyme inhibitor in elderly patients.
    Current Therapeutic Research 12/1993; 54(6):779–787. DOI:10.1016/S0011-393X(05)80707-6 · 0.45 Impact Factor