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  • Title: Enalapril as a first-step agent in essential hypertension: a comparative study with atenolol.
    Author: Edmonds D, Greminger P, Locher R, Knorr M, Vetter H, Vetter W.
    Journal: J Hypertens Suppl; 1986 Dec; 4(5):S406-9. PubMed ID: 3033180.
    Abstract:
    The aim of the present double-blind crossover study was to compare the antihypertensive efficacy and tolerability of enalapril and atenolol in 48 patients with mild to moderate essential hypertension. After a 2-week wash-out period, treatment was started with either enalapril 20 mg or atenolol 50 mg daily. In patients with a diastolic blood pressure value of more than 90 mmHg after 2 weeks of therapy, doses were doubled. After 4 weeks of therapy, cases were classified as responders (diastolic blood pressure less than or equal to 95 mmHg) or non-responders (diastolic blood pressure greater than 95 mmHg) and after a 2-week wash-out phase switched over to the alternative drug for another 4-week therapy period. Both substances significantly lowered mean systolic and diastolic blood pressure to a comparable degree. After 2 weeks, 57% of patients under enalapril and 59% under atenolol shared a satisfactory response, which did not change at the higher dose levels. After 4 weeks of therapy the incidence of side effects was slightly, but insignificantly, higher on atenolol than on enalapril. Thus, our results show that both agents seem equally qualified as first-step drugs in the treatment of mild to moderate essential hypertension.
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