Summary
In 40 patients with essential hypertension, enalapril was compared with propranolol as an antihypertensive agent in a double-blind study. The patients were randomly given either enalapril 5–10–20 mg bid or propranolol 40–80–120 mg bid in a treatment consisting of step-by-step increases in dosage. When the diastolic blood pressure remained >90 mm Hg on the highest dosage, hydrochlorothiazide was added. Both enalapril and propranolol reduced blood pressure, although the patients tended to achieve lower blood pressures while on enalapril. More patients on propranolol required additional diuretic therapy than patients on enalapril.
Propranolol reduced heart rate; with enalapril there were no changes in heart rate. Both drugs increased serum potassium and urea. Plasma renin substrate was reduced by enalapril, but raised by propranolol. Enalapril increased plasma renin activity and angiotensin I, while propranolol reduced both. Converting enzyme activity was lowered with enalapril but was unchanged with propranolol. Both drugs reduced angiotensin II. Plasma aldosterone concentration was more suppressed with propranolol than with enalapril.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Heel RC, Brogden RN, Speight TM, Avery GS (1980) Captopril: a preliminary review of its pharmacological properties and therapeutic efficacy. Drugs 20: 409–452
Editorial (1980) Captopril benefits and risks in severe hypertension. Lancet 1: 129–130
Edwards CRW, Padfield PL (1985) Angiotensin-converting enzyme inhibitors: past, present and the bright future. Lancet 1: 30–34
Vlasses PH, Rotmensch HH, Swanson BN, Irvin JD, Lee RB, Koplin JR, Ferguson FK (1983) Comparative antihypertensive effects of enalapril maleate and hydrochlorothiazide, alone and in combination. J Clin Pharmacol 23: 227–233
Gavras H, Waeber B, Gavras I, Biollaz J, Brunner HR, Davies RO (1981) Antihypertensive effect of the new oral angiotensin converting enzyme inhibitor “MK 421.” Lancet 2: 543–547
Fouad FM, Tarazi RC, Bravo EL (1983) Cardiac and haemodynamic effects of enalapril. J Hypertension 1 [Suppl 1]: 135–142
Leeuw PW de, Hoogma RPLM, Soest GAW van, Tchang PT, Birkenhaeger WH (1983) Humoral and renal effects of MK 421 (enalapril) in hypertensive subjects. J Cardiovasc Pharmacol 5: 731–736
Boer P, Geyskes GG (1985) Apparently high plasma angiotensin II levels in patients with essential hypertension treated by converting enzyme inhibition. Scand J Clin Lab Invest 45: 77–81
Boer P, Hené RJ, Koomans HA, Nieuwenhuis MG, Geyskes GG, Dorhout Mees EJ (1983) Blood and extracellular fluid volume in patients with Bartter's syndrome. Arch Int Med 143: 1902–1905
Hurst PL, Lovell-Smith CJ (1981) Optimized assay for serum angiotensin converting enzyme activity. Clin Chem 27: 2048–2052
Boer P, Roos JC, Geyskes GG, Dorhout Mees EJ (1980) Observations on plasma renin substrate in the nephrotic syndrome. Nephron 26: 121–125
Simon AC, Levenson JA, Bouthier JD, Benetos A, Achimastos A, Fouchard M, Maarek B, Safar M (1984) Comparison of oral MK 421 and propranolol in mild to moderate essential hypertension and their effects on arterial and venous vessels of the forearm. Am J Cardiol 53: 781–785
Hypertension Study Group (1984) Enalapril in essential hypertension a comparative study with propranolol. Br J Clin Pharmacol 18: 51–56
Wilkins LH, Dustan HP, Findley Walker J, Oparil S (1983) Enalapril in low-renin essential hypertension. Clin Pharmacol Ther 34: 297–302
Omvik P, Lund-Johansen P (1984) Combined captopril and hydrochlorothiazide in severe hypertension: Long-term haemodynamic changes at rest and during exercise. J Hypertension 2: 73–80
Rotmensch HH, Vlasses PH, Swanson BN, Irvin JD, Harris KE, Merrill DG, Ferguson RK (1984) Antihypertensive efficacy of once daily MK-521, a new nonsulfhydryl angiotensin-converting enzyme inhibitor. Am J Cardiol 53: 116–119
Morioka S, Simon G, Cohn JN (1983) Cardiac and hormonal effects of enalapril in hypertension. Clin Pharmacol Ther 34: 583–589
Reid JL, Millar JA, Campbell BC (1983) Enalapril and autonomic reflexes and exercise performance. J Hypertension 1 [Suppl 1]: 129–134
Millar JA, Derkx FHM, McLean K, Reid JL (1982) Pharmacodynamics of converting enzyme inhibition: the cardiovascular, endocrine and autonomic effects of MK 421 (enalapril) and MK 521. Br J Clin Pharmacol 14: 347–355
Coghlan JP, Blair-West JR, Denton DA, Fei DT, Fernley RT, Hardy KT, Mc Dougall JG, Puy R, Robinson PM, Scoggins BA, Wright RD (1979) Control of aldosterone secretion. J Endocrinol 81: 55P-67P
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
van Schaik, B.A.M., Geyskes, G.G., Kettner, N. et al. Comparison of enalapril and propranolol in essential hypertension. Eur J Clin Pharmacol 29, 511–516 (1986). https://doi.org/10.1007/BF00635885
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00635885