Contemporary aspects of treatment of mild and moderate hypertension. Results of a multicenter study of antihypertensive effect of enalapril assessed by 24-hour blood pressure monitoring

Antihypertensive efficacy safety and tolerability of enalapril were studied in 2095 patients with hypertension enrolled in 80 centers in Russia. The d ose of enalapril was titrated from 5 to 20 mg with 4 weeks intervals and hy drochlorothiazide was added if blood pressure (BP) lowering was insufficien t. Twenty four hour BP monitoring was used for control of therapy. Initial values of office BP were 160,1+/-0,95/99,6+/-0,59 mm Hg and those obtained during 24-hour monitoring 151,3+/-0,83/92,3+/-0,47 mm Hg. After 4, 8 and 12 weeks of therapy with enalapril average 24-hour BP decreased by 6,8/6,0; 7 ,9/10,8 and 9,9/11,0%, respectively (p<0,001). Significant decreases of sys tolic BP variability index were also observed after 4 (-6%, p<0,02) and 12 (-13,3%, p<0,001) weeks of therapy. Addition of hydrochlorothiazide was req uired in 26% of patients. Efficacy of monotherapy with enalapril was 82%, i n 77% of patients it was considered <<excellent>> or <<good>>. Combination with hydrochlorothiazide increased number of responders up to 91%. Enalapri l was stopped because of side effects in 1,2% of patients. Thus therapy wit h enalapril was associated with high antihypertensive efficacy, good tolera bility and low frequency of side effects.