Duration of angiotensin-converting enzyme inhibition: implications for tolerability

Area of Science:

• Pharmacology
• Clinical Trials
• Cardiovascular Medicine

Background:

• Hypertension management often involves angiotensin-converting enzyme (ACE) inhibitors.
• Comparative safety data for ACE inhibitors like lisinopril, enalapril, and captopril are crucial for clinical decision-making.

Purpose of the Study:

• To compare the incidence of adverse events and withdrawals among lisinopril, enalapril, and captopril in patients with hypertension.
• To assess the safety profiles of these ACE inhibitors across different patient demographics, including age.

Main Methods:

• A multinational clinical-trial program involving patients with hypertension.
• Comparative analysis of adverse events and treatment withdrawals between lisinopril and enalapril groups (n=318 vs. n=321).
• Comparative analysis of adverse events and treatment withdrawals between lisinopril and captopril groups (n=230 vs. n=235).

Main Results:

• The incidence of adverse events was similar for lisinopril versus enalapril (10.4% vs. 8.7%) and lisinopril versus captopril (11.7% vs. 11.9%).
• Withdrawal rates were comparable across all three drug groups, with no significant differences observed.
• The safety profiles were consistent across different age groups, and adverse events reflected known class-specific effects of ACE inhibitors.

Conclusions:

• Lisinopril, enalapril, and captopril demonstrate comparable safety profiles in the management of hypertension.
• Long-acting ACE inhibitors do not appear to confer additional side-effect risks.
• The study supports the use of these ACE inhibitors with similar safety expectations.