Evaluation of Antihypertensive Efficacy of Lisinopril Compared to Metoprolol in Moderate to Severe Hypertension

Abstract

A double-blind controlled, randomized, parallel, multicenter 12-week study was conducted to compare the antihypertensive efficacy of lisinopril with that of metoprolol in treatment of moderate to severe hypertension. Initially. 118 patients were recruited on lisinopril and 61 on metoprolol; and for the purpose of efficacy analysis at week 8, 115 patients on lisinopril and 60 on metoprolol were included. The doses of lisinopril or metoprolol were 40–80 mg/day and 100–200 mg/day, respectively. At week 4, the pretreatment diastolic blood pressure of 111 mm Hg was decreased to 97 mm Hg (p < 0.01) with lisinopril: metoprolol decreased the diastolic blood pressure from 110 to 99 mm Hg (p < 0.01). Similar decreases were noted at week 8; however, the drop in blood pressure with lisinopril was not significantly different from that with metoprolol. Systolic blood pressure also demonstrated a decrease of about 18 mm Hg with lisinopril and 12 mm Hg with metoprolol (p < 0.01). This larger decrease in systolic blood pressure with lisinopril was statistically significant at week 4 (p < 0.05). These decreases in systolic blood pressures were maintained at week 8, again with statistical significance (p < 0.01). Of the 118 lisinopril-treated patients, four were discontinued from lisinopril therapy because of headache, dizziness, rash, flushing, or lymphadenopathy. Four patients out of 61 (9.8%) were discontinued from metoprolol therapy because of fatigue, somnolence, asthenia, weight gain, flatulence, tremor, or bronchospasm. In conclusion, lisinopril 40–80 mg once daily is as effective as metoprolol 100–200 mg once daily in reducing diastolic blood pressure in patients with moderate to severe hypertension. Lisinopril produced a greater reduction in systolic and mean arterial pressures. Therefore, it was concluded that lisinopril was a well-tolerated and effective antihypertensive drug in doses ranging from 40 to 80 mg a day during the 8-week period of this investigation.