The effects of mibefradil and enalapril on 24-hour blood pressure control and left ventricular mass in patients with mild to moderate hypertension: double-blind, randomized trial
Martina, B.; Lorz, W.; Frach, B.; Bart, T.; Battegay, E.J.
Journal of Cardiovascular Pharmacology 33(4): 647-651
1999
ISSN/ISBN: 0160-2446 PMID: 10218737 Document Number: 501351
In this prospective, double-blind, monocenter drug trial, 48 primary care patients with mild to moderate essential hypertension were randomized to mibefradil, 50 mg, titrated to 100 mg, or enalapril, 20 mg, titrated to 2 X 20 mg. Ambulatory 24-h blood pressure measurements (ABPM) and echocardiography were performed at baseline and after 12 weeks' treatment. Complete data from 43 patients were analyzed. Mibefradil (n 22; titration, 13 patients) reduced mean 24-h ABP from 159 +- 14/102 +- 7 mm Hg to 140 +- 10/89 +- 7 mm Hg after 12 weeks. Enalapril (n = 21; titration, six patients) reduced baseline ABP from 156 +- 12/100 +- 9 mm Hg to 140 +- 17/89 +- 10 mm Hg (12 weeks). Trough-to-peak ratios in DBP were 86% for mibefradil and 75% with enalapril. Left ventricular mass (LVM) decreased from 199 +- 65 to 193 +- 62 g (M-mode modified American Society of Echocardiography (ASE)) and from 184 +- 65 to 173 +- 50 g (truncated ellipsoid method) after 12 weeks in response to mibefradil (p > 0.2), and from 212 +- 50 to 196 +- 57 g and from 182 +- 39 to 170 +- 40 g (mean +- SD, p < 0.02) with enalapril. Mibefradil matched enalapril in 24-h ABP control. Enalapril reduced LVM significantly after 12 weeks (p < 0.02). Mibefradil did not significantly reduce LVM after 12 weeks.