LISINOPRIL BETTER THAN ENALAPRIL?

Many studies have indicated that lisinopril (Zeneca's Zestril) and enalapril (Merck & Co's Vasotec) are equally potent in single daily doses for controlling mild to moderate hypertension. However, a new study published in Clinical and Experimental Hypertension (1993; 15(1) 71-89), has revealed pharmacokinetic properties of lisinopril which may mean it is more effective than enalapril in controlling blood pressure.

The major difference between the two ACE inhibitors occurred after four to five weeks of continuous, daily therapy, when the mean systolic blood pressure was found to be significantly lower (by 53%) with lisinopril therapy. This reduction was found to be primarily in the latter half of the 24-hour dosage interval. A similar but non-significant trend was observed for diastolic blood pressure.

In an attempt to explain this finding, the authors of the study suggest that lisinopril causes more prolonged ACE inhibition in plasma and at other sites in the body, such as the lung, kidney and adrenals.