December 1, 1994Clinical Pharmacology & Therapeutics
Discordant effects of enalapril and lisinopril on systemic and renal hemodynamics
Key result
Enalapril improves effective renal plasma flow ~5-fold more than lisinopril despite comparable blood pressure reductions.
- P=0.018
- n=8
Why the study?
Does enalapril have different effects on systemic and renal hemodynamics compared to lisinopril in patients with essential hypertension?
Population
8 patients with essential hypertension
Comparison
Enalapril (20 mg) vs Lisinopril (20 mg) in a crossover design
Design
Other, single-blind
Follow-up
12-month
Authors
Discussion
Loading...
Member takes
Implication
Should not yet guide ACEI selection in hypertension; leaves open whether renal flow differences affect outcomes.
Study Design
Type
RCT (n=8)
Blinding
Single-blind
Structured PICO
Does enalapril have different effects on systemic and renal hemodynamics compared to lisinopril in patients with essential hypertension?
P
Population
8 patients with essential hypertension evaluated in a 12-month single-blind crossover study.
I
Intervention
Enalapril (20 mg)
C
Comparator
Lisinopril (20 mg) in a crossover design
O
Outcome
Blood pressure and renal hemodynamics (effective renal plasma flow, filtration fraction, and renovascular resistance) during ACE inhibition and/or angiotensin II infusionsurrogate
Main Result
Absolute Event Rate: 21.9% vs 4.4%
p-value: p=0.018
Enalapril exerts more pronounced effects on renal hemodynamics than lisinopril in patients with essential hypertension, despite comparable systemic blood pressure reductions.
Cite This Study
Apperloo et al. (1994) conducted an RCT in essential hypertension (n=8). Enalapril vs. Lisinopril (20 mg) was evaluated on change in effective renal plasma flow (ERPF) (p=0.018). Enalapril increased effective renal plasma flow significantly more than lisinopril (21.9% vs 4.4%, p=0.018) despite comparable systemic blood pressure reductions.