1987•Journal of Cardiovascular PharmacologyRequires access
The Antihypertensive Effect of Lisinopril Compared to Atenolol in Patients with Mild to Moderate Hypertension
K. Bolzano, Jaime J. Arriaga, Rodolfo Bernal, Hélio Bernardes, Javier Calderón, Jennifer C. C. deBruyn, Franz Dienstl, J. I. M. Drayer, Theodore L. Goodfriend, Walter B. Gross, Gordon P. Guthrie, N. J. Holwerda, Wojciech Klein, L R Krakoff, H. Liebau, Suzanne Oparil, Garry P. Reams, William Gary Reed, M Safar, Rolf Schubotz, Yackoob Kassim Seedat, Gurdarshan S. Thind, Yosuf Veriava, Gary L. Wollam, J W Woods, Randall Mark Zusman
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Abstract
In a multicenter, parallel, double-blind study, lisinopril was compared with atenolol in the treatment of mild to moderate essential hypertension. Four hundred ninety patients were randomized to a once-a-day treatment with lisinopril 20 mg or atenolol 50 mg for 4 weeks, and the doses of lisinopril or atenolol were increased up to 80 mg or 200 mg, respectively, at 4-week intervals if sitting diastolic blood pressure (SDBP) was not well controlled. Hydrochlorothiazide (HCTZ) 12.5 or 25 mg was added after 12 weeks, if necessary, and titrated upward after 4 weeks to a maximum dose of 25 or 50 mg/day. Lisinopril and atenolol reduced SDBP to a similar extent. All reductions from baseline in sitting diastolic and systolic blood pressure were significant (less than 0.01). Lisinopril produced a significant (less than 0.01) greater reduction in sitting systolic blood pressure (SSBP) than atenolol. Addition of HCTZ caused further blood pressure reductions (p less than 0.01). Five patients (1.7%) on lisinopril and four (2.0%) on atenolol developed skin rashes during weeks 1-12. Two patients (0.7%) on lisinopril 80 mg developed proteinuria (greater than 1 g/day). Cough occurred more often with lisinopril (4.5%), and elevated triglycerides occurred more often with atenolol (2.0%).