Effects of Losartan and Lisinopril on the Ambulatory Blood Pressure in Previously Untreated Patients with Mild to Moderate Essential Hypertension

The aim of this study was to compare the effects of two long-acting antihypertensive agents, the ACE inhibitor lisinopril and the angiotensin II type 1 receptor antagonist losartan on clinical and ambulatory blood pressure in previously untreated patients with mild to moderate essential hypertension. 60 patients between 33 and 67 years of age with systolic blood pressure >140 and <179 mmHg and diastolic blood pressure >90 and <109 mmHg were randomized to receive either 10-20 mg lisinopril (n=30) once a day or 50-100 mg losartan (n=30) once a day for 12 weeks. The drugs were titrated after 4 weeks if systolic blood pressure >140 mmHg and diastolic blood pressure >90 mmHg. Routine laboratory, office and ambulatory blood pressure measurements were assessed at baseline and at 12 weeks. With losartan and lisinopril clinical systolic and diastolic blood pressure (S/DBP) values decreased by 20.8/15.2 and 16.8/12.2 and 24-hour mean S/DBP by 15.1/9.9 and 13.6/8.5 mmHg, respectively (p<0.0001). Losartan reduced clinical S/DBP values to a significantly greater extent than lisinopril (p<0.05). Although both losartan and lisinopril were found to be effective in reducing blood pressure in patients with mild to moderate essential hypertension, the decrease in S/DBP with losartan was greater compared to lisinopril. Randomized studies with larger patient populations should be conducted to compare directly the two different treatment regimens.