Lisinopril versus slow release nifedipine in patients with essential hypertension: a multicentre study

The present study was performed to investigate the efficacy and safety of the angiotensin converting enzyme (ACE) inhibitor lisinopril compared with those of the calcium channel blocker nifedipine in 293 patients with mild to moderate essential hypertension (supine diastolic blood pressure (DBP) 95-115 mmHg) in a multicentre, randomised, double-blind parallel group study after a two week single-blind placebo run-in period. Thus, the haemodynamic effects as well as side-effects during antihypertensive treatment were examined in 146 patients receiving lisinopril (20 mg once daily) and in 147 patients receiving slow release nifedipine (20 mg twice daily) who entered the six weeks' treatment period. From the analysis of efficacy one patient from the lisinopril and two patients from the nifedipine groups were excluded because their supine DBP after run-in was < 95 mmHg. Adverse reactions, mostly transient during the initial treatment period, and withdrawals occurred in six (4.1%) and three (2.1%) patients of the lisinopril group and in 12 (8.2%; NS) and three (2.0%) patients of the nifedipine group, respectively. After the six weeks' treatment period the lisinopril group showed 19 nonresponders (supine DBP > or = 95 mmHg) of the remaining 142 patients and the nifedipine group revealed 20 nonresponders of the remaining 142 patients. Initial supine and standing heart rates were similar in both groups. Supine heart rate fell significantly in the lisinopril group, whereas standing heart rate in this group and supine and standing heart rates in the nifedipine group did not change significantly with treatment. Thus, lisinopril proved to be as effective and safe as nifedipine with responder rates of 86.6% and 85.9%, respectively.