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Benazepril at incremental doses in essential hypertension
R Fogari1, F Tettamanti, L Poletti
1Department of Internal Medicine and Therapeutics, University of Pavia, Italy.
International Journal of Clinical Pharmacology, Therapy, and Toxicology
|February 1, 1990
Summary
Benzepril effectively lowers blood pressure in patients with essential hypertension. Some patients respond quickly to 10 mg, while others require a higher dose for optimal antihypertensive effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension is a widespread condition requiring effective treatment.
- Angiotensin-converting enzyme (ACE) inhibitors are a cornerstone of antihypertensive therapy.
Purpose of the Study:
- To evaluate the antihypertensive efficacy of benzepril, a novel non-sulphydryl ACE inhibitor.
- To assess the dose-response relationship and identify patient characteristics influencing treatment response.
Main Methods:
- A 2-week placebo run-in period was followed by treatment with benzepril (10 mg daily).
- Patients with uncontrolled diastolic blood pressure (DBP ≥ 95 mmHg) were up-titrated to 20 mg daily.
- Blood pressure (BP) and heart rate (HR) were monitored every two weeks for 4 weeks.
Main Results:
- Benzepril significantly reduced systolic blood pressure (SBP) and DBP (p < 0.01) without affecting HR.
- 43% of patients were "fast responders" (DBP < 95 mmHg) after 2 weeks at 10 mg.
- Up-titration to 20 mg benefited "slow responders", achieving significant BP reduction (-16/-10 mmHg).
- Fast responders were younger, had lower baseline BP, and shorter hypertension duration.
Conclusions:
- Benzepril demonstrates significant antihypertensive effects in patients with essential hypertension.
- A flexible dosing strategy, including up-titration, enhances treatment efficacy.
- Patient characteristics may predict response to benzepril therapy.