ACE inhibitors in mild to moderate hypertension: comparison of lisinopril and captopril administered once daily. French Cooperative Study Group

Abstract

A double-blind, parallel-group, multicentre study was carried out to compare the effects of once-daily treatment with lisinopril 20 mg and captopril 50 mg in 304 patients with mild to moderate hypertension. Following a 2-week placebo run-in period, patients with a lying DBP between 95 and 115 mmHg were randomised to either active treatment for 10 weeks. BP measurements were made approximately 24 h after the previous dose of either drug. After 6 weeks, hydrochlorothiazide 25 mg once daily was added for patients with a lying DBP greater than or equal to 95 mmHg and a final assessment was made in all patients after a further 4 weeks of treatment. After 6 weeks of monotherapy, lisinopril had reduced lying and standing BP by an average of 18/14 mmHg and 19/12 mmHg, respectively, compared with 15/12 mmHg and 14/11 mmHg respectively for captopril. The larger fall in SBP with lisinopril was statistically significant (lying SBP, P = 0.01; standing SBP, P = 0.0001). In addition, a significantly larger proportion of patients achieved BP control (DBP less than 95 mmHg) with lisinopril than with captopril (79% versus 67%; P = 0.02). Neither drug significantly altered heart rate. The addition of hydrochlorothiazide in some patients produced a further, small reduction in mean BP in both groups although, 10 weeks after randomisation, the proportion of patients in whom BP control had been achieved with lisinopril was still significantly greater than that achieved with captopril (90% versus 79%; P = 0.02). Both drugs were well tolerated and no serious adverse events occurred during the study.(ABSTRACT TRUNCATED AT 250 WORDS)