A comparison of enalapril 20 mg once daily versus 10 mg twice daily in terms of blood pressure lowering and patient compliance

Abstract

Objective: To compare enalapril 20 mg once daily with 10 mg twice daily in terms of blood pressure reduction and patient compliance.

Design: Cross-over study of patients randomly assigned to a sequence of enalapril 20 mg once daily or 10 mg twice daily in three 4-week periods following a 4-week placebo run-in.

Setting: General practices in the greater Belfast and Lisburn area in Northern Ireland.

Patients: Twenty-five hypertensive patients who had a mean diastolic blood pressure of between 90 and 110 mm Hg after receiving placebo for 4 weeks.

Main outcome measures: Reduction in blood pressure and estimation of patient compliance.

Results: Patient compliance was superior on the once daily regimen. However, the twice daily regimen was associated with a greater blood pressure reduction which almost reached statistical significance at the 5% level.

Conclusions: Enalapril 20 mg should be prescribed as 10 mg twice daily and measures taken to improve patient compliance.