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Acute antihypertensive effect of angiotensin converting enzyme inhibition and calcium entry blockade
H R Brunner1, J Nussberger, J Bidiville
1Division of Nephrology and Hypertension, Centre Hospitalier Universitaire, Lausanne, Switzerland.
Insights
This study compared angiotensin converting enzyme inhibitor (enalaprilat) and calcium entry blocker (nifedipine) for acute blood pressure reduction in hypertension. Both drugs effectively lowered blood pressure, but patient responses varied between the two medications.
Area of Science:
- Cardiovascular medicine
- Pharmacology
- Hypertension research
Background:
- Essential hypertension is a common condition requiring effective blood pressure management.
- Angiotensin converting enzyme inhibitors and calcium entry blockers are established antihypertensive drug classes.
- Understanding comparative acute responses is crucial for treatment selection.
Purpose of the Study:
- To compare the acute blood pressure lowering effects of enalaprilat and nifedipine.
- To assess the consistency of patient response to these two different antihypertensive agents.
Main Methods:
- A randomized, crossover study design was employed.
- Patients with uncomplicated essential hypertension underwent a 3-week washout period.
- Intravenous enalaprilat (5 mg) and oral nifedipine (10 mg) were administered 48 hours apart.
Main Results:
- Both enalaprilat and nifedipine demonstrated comparable efficacy in acutely reducing blood pressure.
- Individual patient responses to enalaprilat did not reliably predict responses to nifedipine.
Conclusions:
- Enalaprilat and nifedipine offer similar acute blood pressure control in hypertensive patients.
- Patient-specific responses suggest a need for individualized treatment strategies rather than a one-size-fits-all approach.
Abstract:
The acute blood pressure response to an angiotensin converting enzyme inhibitor (enalaprilat) was compared in patients with uncomplicated essential hypertension with that obtained under similar conditions with a calcium entry blocker (nifedipine). The patients were studied after a 3 week washout period. At a 48 h interval, each patient received in randomized order either enalaprilat (5 mg i.v.) or nifedipine (10 mg p.o.). Enalaprilat and nifedipine were equally effective in acutely lowering blood pressure. However, good responders to one agent were not necessarily good responders to the other.