Thomson M, Droussin A M, De Lame P A
Merck Sharp & Dohme, Brussels, Belgium.
Acta Cardiol. 1990;45(4):297-309.
The safety and efficacy of lisinopril in the treatment of mild to moderate essential hypertension was evaluated by Belgian general practitioners in patients whose hypertensive condition remained uncontrolled by previous treatment and/or in whom the prior drug regimen was not tolerated. In this 8-week study, 3060 eligible patients were initially treated with 20 mg lisinopril once daily; this dose was increased to 40 mg if diastolic blood pressure (DBP) was greater than 90 mm Hg after 4 weeks. Lisinopril monotherapy in the 1902 patients completing the trial resulted in marked reductions of systolic (SBP) and DBP from 172.5/102.4 mm Hg at baseline to 147.4/86.6 mm Hg by week 8. More than 90% of patients achieved a DBP less than 95 mm Hg. The decrease in blood pressure was similar in patients older and younger than 65 year of age. Only about 20% of patients required an increase in their daily intake of lisinopril to 40 mg. Treatment was well tolerated and the profile of adverse events was similar to the pattern found with other nonsulfydryl angiotensin converting enzyme inhibitors. Tolerance in the elderly was similar to that experience by hypertensives under 65 years of age. Thus, lisinopril at 20 or 40 mg once daily proved both well tolerated and effective in reducing blood pressure in patients with mild to moderate essential hypertension.
比利时全科医生对赖诺普利治疗轻至中度原发性高血压的安全性和有效性进行了评估，这些患者的高血压病情此前治疗未能控制，和/或不能耐受先前的药物治疗方案。在这项为期8周的研究中，3060名符合条件的患者最初每日一次服用20mg赖诺普利；如果4周后舒张压（DBP）大于90mmHg，则将剂量增加至40mg。完成试验的1902例患者采用赖诺普利单药治疗，收缩压（SBP）和DBP从基线时的172.5/102.4mmHg显著降至第8周时的147.4/86.6mmHg。超过90%的患者DBP降至95mmHg以下。65岁及以上和65岁以下患者的血压下降情况相似。只有约20%的患者需要将赖诺普利的每日摄入量增加至40mg。治疗耐受性良好，不良事件情况与其他非巯基血管紧张素转换酶抑制剂相似。老年人的耐受性与65岁以下高血压患者相似。因此，每日一次服用20mg或40mg赖诺普利在轻至中度原发性高血压患者中证明耐受性良好且能有效降低血压。
