EFFECTS OF BENAZEPRIL ON STRESS-TESTING BLOOD-PRESSURE IN ESSENTIAL-HYPERTENSION

The effects of different doses of the angiotensin converting enzyme in hibitor benazepril on cardiovascular response to a set of standardized laboratory tasks were analyzed. Eighteen patients (15 men and 3 women ) with mild-to-moderate essential hypertension were randomly allocated to receive 10 or 20 mg of benazepril, or placebo, each administered o nce daily for 2 weeks, according to a double-blind, 3-period design. A t the end of each treatment period, patients were examined at resting baseline and while performing mental arithmetic, handgrip and cycle er gometry tests. In comparison with placebo, the average reductions in r esting systolic blood pressure (BP) were 8.7 mm Hg (95% confidence int ervals [CI] -15.2 to -2.1) with 10 mg of benazepril, and 7.8 mm Hg (95 % CI -14.4 to -1.3) with 20 mg; the corresponding reductions in restin g diastolic BP were 5.1 mm Hg (95% CI -8.7 to -1.4) and 6.8 mm Hg (95% CI -10.4 to -3.1) (all p < 0.05). During mental arithmetic, the reduc tions in systolic BP were 10.4 mm Hg (95% CI -17.4 to -3.4) with 10 mg of benazepril, and 13.8 mm ng (95% CI -20.8 to -6.8) with 20 md diast olic BP was reduced by 4.5 mm Hg (95% CI -8.5 to -0.5) and 8.3 mm ng ( 95% CI -13.2 to -4.3), respectively (all p < 0.05). During the handgri p test, systolic and diastolic BP were significantly reduced after 20 mg of benazepril by 10.8 mm Hg (95% CI -20.6 to -1) and as mm Hg (95% CI -12.7 to -1.1), respectively (both p < 0.05); the reductions in sys tolic and diastolic BP observed after 10 mg of benazepril did not achi eve statistical significance (9.2 mm Hg [95% CI -19.1 to 0.6] and 2.1 mm Hg [95% CI -7.9 to 3.7], respectively; both p > 0.05). During ergom etry, no active treatment significantly affected systolic and diastoli c BP values (all p > 0.05). During mental arithmetic and the handgrip test, there was no treatment effect on the magnitude of BP reactivity from baseline (all p > 0.05); during ergometry, systolic BP reactivity was higher after both benazepril doses than after placebo (both p < 0 .05). The data suggest that benazepril, especially at higher doses, ma y be effective in reducing BP not only at rest, but also during some c ommonly recurring stressful situations.