LISINOPRIL VERSUS KETANSERIN IN ELDERLY HYPERTENSIVES - HEMODYNAMIC AND ENDOCRINE EFFECTS

This randomised, double-blind, cross-over study was designed to compar e lisinopril with ketanserin in the treatment of hypertension in elder ly hospital outpatients. Eight patients with diastolic (<90mmHg) and/o r systolic (>160mmHg) essential hypertension without insulin-dependent diabetes or significant renal or hepatic dysfunction were enrolled. A two-week washout period was followed by It weeks treatment with eithe r ketanserin, 20-40mg, or lisinopril, 10-40mg daily. After another fou r-week washout period, 12 weeks treatment with the alternate medicatio n was given with a further four-week washout period The effects of tre atment on casual and 24-hour ambulatory blood pressure, quality of lif e, plasma renin activity (PRA), aldosterone, catecholamines and atrial natriuretic peptide (ANP) were monitored. Both drugs reduced supine s ystolic (p<0.05) and diastolic (p=0.07) blood pressures while lisinopr il, but not ketanserin, significantly reduced the 24-hour ambulatory o verage systolic blood pressures. Quality of life was not significantly affected by treatment with either drug. Treatment with lisinopril but not ketanserin resulted in increased PRA and decreased aldosterone. T reatment with ketanserin but not lisinopril resulted in lower plasma n oradrenaline concentrations (p<0.05) and tended to lower the plasma gl ucose concentrations (p=0.07). Plasma adrenaline and ANP were not sign ificantly affected after treatment with either drug. It is concluded t hat both ketanserin and lisinopril ore well tolerated in the elderly a nd are effective in reducing casually measured blood pressure. Lisinop ril significantly reduced the 24-hour ambulatory blood pressure profil e.