A COMPARATIVE-STUDY OF THE EFFICACY AND TOLERABILITY OF AMLODIPINE AND LISINOPRIL IN THE TREATMENT OF ESSENTIAL-HYPERTENSION

An open randomised crossover study was conducted to assess the efficac y and tolerability of amlodipine (5 to 10 mg/day) and lisinopril (10 t o 20 mg/day) in the treatment of 20 patients with mild to moderate ess ential hypertension. At baseline and after completion of each 3-month treatment phase, physical examination, electrocardiography, blood chem istry studies and 24-hour ambulatory blood pressure monitoring were pe rformed. Both drugs significantly reduced systolic and diastolic blood pressures compared with baseline, although the reduction observed wit h amlodipine was significantly greater than that observed with lisinop ril (23.5 vs 16.5 mm Hg for sitting systolic blood pressure; 21.1 vs 1 3.8 mm Hg for sitting diastolic blood pressure). None of the patients experienced significant changes in heart rate during either phase of t he study, and neither drug altered the circadian rhythm of blood press ure fluctuations seen at baseline. 35% of patients treated with the lo wer dosage of amlodipine (5 mg/day) experienced adequate blood pressur e control, whereas only 10% could be successfully controlled with the initial dosage of lisinopril (10 mg/day). All patients were successful ly controlled with the higher dosages. No significant adverse effects were seen during treatment with either amlodipine or lisinopril. These findings suggest that amlodipine provides effective central of blood pressure in patients with mild to moderate hypertension.