Antihypertensive Effect and Acceptability of Perindopril

Abstract

The aim of this 3-month double-blind study was to assess the antihypertensive effect and acceptability of perindopril in comparison with atenolol in patients with mild to moderate essential hypertension. After a 4-week run-in placebo period, 40 patients with supine diastolic blood pressure (DBP) between 95 and 120mm Hg were randomised to receive perindopril 4mg or atenolol 50mg once daily. If supine DBP was> 90mm Hg, treatment was adjusted monthly: first by doubling the dose and then by the addition of chlorthalidone 50mg. Except for standing DBP, which was higher in the perindopril group than in the atenolol group, the 2 groups were homogeneous prior to treatment. After 3 months of active treatment, the decrease in supine blood pressure and standing DBP was not significantly different between the 2 groups. In contrast, the fall in standing systolic blood pressure was greater with perindopril than with atenolol. The percentage of patients (85%) who achieved supine DBP of ~ 90mm Hg in the perindopril group was not significantly different from the atenolol group (80%). Monotherapy resulted in control of supine DBP in 55% of the perindopril group and 65% of the atenolol group; the addition of chlorthalidone resulted in control of supine DBP in 30 and 15%, respectively. No patient was withdrawn from the study. The nature and incidence of side effects were similar between the 2 groups. Changes in laboratory parameters were minor and not significantly different between the 2 groups.Perindopril was as effective as atenolol in lowering blood pressure. Clinical and biological acceptability was satisfactory and similar with both drugs. Perindopril may therefore be recommended as first-line treatment for mild to moderate essential hypertension.