Enalapril and atenolol in essential hypertension: Attenuation of hypotensive effects in combination

L. M.H. Wing; J. P. Chalmers; M. J. West; A. E. Russell; M. J. Morris; M D. Cain; A J C  Bune; D. O. Southgate

doi:10.3109/10641968809046803

Enalapril and atenolol in essential hypertension: Attenuation of hypotensive effects in combination

L. M.H. Wing, J. P. Chalmers, M. J. West, A. E. Russell, M. J. Morris, M D. Cain, A J C Bune, D. O. Southgate

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Abstract

In 16 patients with essential hypertension the effects of enalapril 20 mg once daily were compared with those of atenolol 50 mg once daily, with the two drugs in combination and with placebo using a double-blind cross-over design with allocation of treatment order by randomised Latin squares. For each patient there were four treatment phases, each of four weeks duration, which together comprised a 2×2 factorial experiment. All blood pressure parameters were reduced in the three active treatment phases compared to placebo (p < 0.001). Supine blood pressures (group means) were 171/97 (placebo), 147/85 (enalapril), 154/84 (atenolol) and 144/78 (enalapril plus atenolol) (S.E.M. ± 2/± 1 -ANOVA), and standing blood pressures were 170/105 (placebo), 146/92 (enalapril), 154/92 (atenolol) and 147/86 (enalapril plus atenolol) (S.E.M. ± 3/+1). In the combination phase there was an additional hypotensive response but the potential fully additive effects of the two agents were attenuated by 30-50% The mechanism of the attenuated hypotensive effect of the combined agents has not been determined. Plasma atrial natriuretic peptide (ANP) concentration was doubled in the presence of atenolol (P < 0.01) suggesting that ANP may contribute to the hypotensive effect of the beta-blocker.

Original language	English
Pages (from-to)	119-133
Number of pages	15
Journal	Clinical and Experimental Hypertension
Volume	10
Issue number	1
DOIs	https://doi.org/10.3109/10641968809046803
Publication status	Published - 1 Jan 1988

Keywords

Angiotensin converting enzyme Inhibitors
Atenolol
Atrial natriuretic peptide
Blood pressure
Enalapril
Renin-angiotensin system

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title = "Enalapril and atenolol in essential hypertension: Attenuation of hypotensive effects in combination",

abstract = "In 16 patients with essential hypertension the effects of enalapril 20 mg once daily were compared with those of atenolol 50 mg once daily, with the two drugs in combination and with placebo using a double-blind cross-over design with allocation of treatment order by randomised Latin squares. For each patient there were four treatment phases, each of four weeks duration, which together comprised a 2×2 factorial experiment. All blood pressure parameters were reduced in the three active treatment phases compared to placebo (p < 0.001). Supine blood pressures (group means) were 171/97 (placebo), 147/85 (enalapril), 154/84 (atenolol) and 144/78 (enalapril plus atenolol) (S.E.M. ± 2/± 1 -ANOVA), and standing blood pressures were 170/105 (placebo), 146/92 (enalapril), 154/92 (atenolol) and 147/86 (enalapril plus atenolol) (S.E.M. ± 3/+1). In the combination phase there was an additional hypotensive response but the potential fully additive effects of the two agents were attenuated by 30-50% The mechanism of the attenuated hypotensive effect of the combined agents has not been determined. Plasma atrial natriuretic peptide (ANP) concentration was doubled in the presence of atenolol (P < 0.01) suggesting that ANP may contribute to the hypotensive effect of the beta-blocker.",

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AU - Wing, L. M.H.

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AU - West, M. J.

AU - Russell, A. E.

AU - Morris, M. J.

AU - Cain, M D.

AU - Bune, A J C

AU - Southgate, D. O.

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Enalapril and atenolol in essential hypertension: Attenuation of hypotensive effects in combination

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Keywords

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