ENALAPRIL VERSUS ATENOLOL IN THE TREATMENT OF ESSENTIAL HYPERTENSION: A CROSS-OVER PLACEBO CONTROLLED STUDY

Abstract

Purpose: This was conducted in an effort to determine efficacy and safety of Enalapril in the management of blood pressure (BP) on different levels of essential hypertension as compared to Atenolol that is a commonly used beta-blocker as a first line treatment of hypertension.

Methods: A cross-over study was performed because it involved 96 patients with essential hypertension in a part placebo-controlled experiment, where they were not aware of the actual study. Patients received a random allocation of Enalapril (10 mg/day, 20 mg/day and up to 80 mg/day in mild, moderate and severe hypertension respectively) or Atenolol (50 mg/day, or up to 100 mg/day in moderate and severe hypertension). BP was taken at two-week intervals and therapeutic changes given as per individual response. During the study side effects were observed. Findings: Enalapril was more effective in lowering both the systolic and diastolic BP than Atenolol in all haste of hypertension. The best variation in efficacy was achieved on the patients having severe hypertension where Enalapril provided a more significant fall in the BP. Enalapril had few and non-dose-dependent adverse effects whilst the other drug was shown to be well tolerated. In its turn, atenolol was less effective, though it worked. In conclusion, enalapril is a very powerful and well-tolerated antihypertensive in comparison to Atenolol and might be better than it. It is specifically useful in treating moderate and mild hypertension and it lacks some disadvantages to Atenolol in extreme cases and among people with other complications of the heart such as heart failure or bronchial asthma. Its efficacy in isolated systolic hypertension needs to be studied further as well as its best dosing in case of severe disease.