Comparison of labetalol versus enalapril as monotherapy in elderly patients with hypertension: results of 24-hour ambulatory blood pressure monitoring

Article Abstract:

The safety and effectiveness of the drugs labetalol and enalapril, which lower blood pressure, were assessed in 79 elderly patients with hypertension. The standing diastolic blood pressure, obtained during the relaxation phase of the heart cycle while the patient is standing, was between 95 millimeters of mercury (mm Hg) and 114 mm Hg. The patients were treated with either enalapril or labetalol for 12 weeks. Blood pressure and heart rate were measured biweekly, and ambulatory blood pressure monitoring, performed over a 24-hour period, was done both before and eight weeks after the start of drug treatment. Both drugs decreased supine diastolic blood pressure (measured while the patient is lying down). Labetalol caused a greater decrease in standing diastolic pressure compared with enalapril. Over a 24-hour period, labetalol caused greater reductions in diastolic blood pressure and heart rate. Both drugs were well tolerated by the patients. These findings show that labetalol and enalapril are equally effective in reducing supine diastolic blood pressure in elderly hypertensive patients. However, labetalol is more effective than enalapril in maintaining low blood pressure and heart rate over a 24-hour period. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Blood pressure, Antihypertensive drugs, Antihypertensive agents

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Effects of cilazapril on hypertension, sleep, and apnea

Article Abstract:

Sleep apnea is a condition in which breathing stops for longer than 10 seconds during sleep. Up to 10 percent of middle-aged men experience sleep apnea. These people have increased rates of death and disease. More than 50 percent of patients with apnea have hypertension, or abnormally high blood pressure; similarly, up to 50 percent of patients with hypertension have sleep apnea. The relation between sleep apnea and hypertension is of particular importance because antihypertensive drugs increase cardiac insufficiency or impair cardiac function, increase the viscosity or stickiness of the blood, cause sedation, increase the risk of arrhythmias or abnormal heart rhythms, and prevent deep and rapid eye movement sleep. The effects of angiotensin-converting enzyme inhibitors used to treat hypertension were examined in six patients with sleep apnea and hypertension. These antihypertensive agents decreased both blood pressure and sleep apnea, and did not affect sleep structure or the type of sleep experienced, such as the rapid eye movement type. A final evaluation of the effects of angiotensin-converting enzyme inhibitors on sleep apnea will be carried out in an additional 12 patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, ACE inhibitors, Angiotensin converting enzyme inhibitors, Sleep apnea syndromes, Sleep apnea, Cilazapril

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