Comparative effectiveness of perindopril and enalapril in patients with arterial hypertension and obesity

Aim. To assess the antihypertensive effectiveness of perindopril and enalapril, as well as their effects on metabolic parameters, in patients with arterial hypertension (AH) and obesity (O). Material and methods. This blind, randomized, controlled, parallel comparative study included 60 patients with AH and O, who were administered perindopril or enalapril for 24 weeks. Results. Perindopril demonstrated significantly better antihypertensive effectiveness, cardio-, angio-, and nephroprotection, as well as an improvement in lipid, carbohydrate, and purine metabolism parameters. In patients with AH and O, only perindopril had beneficial effects on insulin resistance, hyperleptinemia, and inflammation. In contrast to enalapril treatment, perindopril therapy was associated with a marked improvement in anthropometry parameters and a reduction in fat tissue deposits. Conclusion. In patients with a combination of AH and O, perindopril was superior to enalapril in terms of antihypertensive effectiveness, organ protection, and the effects on key humoral factors determining body mass increase and blood pressure elevation.