Todd P A, Goa K L
Adis International Limited, Auckland, New Zealand.
Drugs. 1992 Mar;43(3):346-81. doi: 10.2165/00003495-199243030-00005.
Enalapril, an angiotensin converting enzyme (ACE) inhibitor usually administered orally once daily, decreases blood pressure by lowering peripheral vascular resistance without increasing heart rate or output. It is effective in lowering blood pressure in all grades of essential and renovascular hypertension. Patients not responding adequately to enalapril monotherapy usually respond with the addition of a thiazide diuretic (or a calcium antagonist or beta-blocker), and rarely require a third antihypertensive agent. Enalapril is at least as effective as other established and newer ACE inhibitors, and members of other antihypertensive drug classes including diuretics, beta-blockers, calcium antagonists and alpha-blockers, but therapy with enalapril may be less frequently limited by serious adverse effects or treatment contraindications than with other drug classes. The most frequent adverse effect limiting all ACE inhibitor therapy in clinical practice is cough. This favourable profile of efficacy and tolerability, and the substantial weight of clinical experience, explain the increasing acceptance of enalapril as a major antihypertensive treatment and supports its use as logical first-line therapeutic option.
依那普利是一种血管紧张素转换酶（ACE）抑制剂，通常每日口服一次，通过降低外周血管阻力来降低血压，而不增加心率或心输出量。它对各种程度的原发性高血压和肾血管性高血压均有效。对依那普利单药治疗反应不佳的患者，加用噻嗪类利尿剂（或钙拮抗剂或β受体阻滞剂）通常会有反应，很少需要第三种抗高血压药物。依那普利至少与其他已确立的和较新的ACE抑制剂以及包括利尿剂、β受体阻滞剂、钙拮抗剂和α受体阻滞剂在内的其他抗高血压药物类别中的药物效果相当，但与其他药物类别相比，依那普利治疗较少受到严重不良反应或治疗禁忌的限制。在临床实践中，限制所有ACE抑制剂治疗的最常见不良反应是咳嗽。这种良好的疗效和耐受性以及丰富的临床经验，解释了依那普利作为主要抗高血压治疗药物越来越被接受，并支持将其作为合理的一线治疗选择。
