How much does lisinopril lower blood pressure
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The Impact of Lisinopril on Blood Pressure Reduction
Introduction to Lisinopril and Blood Pressure Management
Lisinopril is a widely used angiotensin-converting enzyme (ACE) inhibitor prescribed for managing hypertension. Its effectiveness in lowering blood pressure (BP) has been extensively studied across various patient demographics, including children, adults, and the elderly.
Blood Pressure Reduction in Children
A controlled study involving hypertensive children aged 6 to 16 years demonstrated that lisinopril effectively lowers blood pressure in a dose-dependent manner. The study found that an initial dose of 0.07 mg/kg administered once daily significantly reduced both systolic and diastolic BP within two weeks . This reduction was consistent across different subgroups, including age, Tanner stage, ethnicity, and gender.
Efficacy in Elderly Patients
In elderly patients with essential hypertension, lisinopril has shown significant efficacy. Studies indicate that lisinopril reduces sitting systolic BP by 21.0 to 26.1 mmHg and sitting diastolic BP by 11.1 to 17.7 mmHg . These reductions were comparable to those achieved with other antihypertensive agents such as hydrochlorothiazide, atenolol, metoprolol, and nifedipine, with no significant differences in efficacy between these treatments .
Comparative Studies with Other Antihypertensives
Lisinopril has been compared with other antihypertensive medications like enalapril and nifedipine. In a study comparing single doses of lisinopril and enalapril, both drugs caused a marked fall in BP, with effects lasting for 24 hours post-dose . Another study found that lisinopril and nifedipine both effectively controlled BP in elderly hypertensive patients, with lisinopril showing a greater improvement in baroreflex sensitivity .
Dose-Response Relationship
The dose-response relationship of lisinopril in patients with mild to moderate essential hypertension was explored in a multicenter study. The study revealed a linear dose-response relationship, with higher doses (20 and 80 mg/day) resulting in significantly greater reductions in both supine and erect BP compared to lower doses and placebo . This indicates that the antihypertensive effect of lisinopril increases with higher doses.
Long-Term Efficacy and Safety
Lisinopril has been shown to produce a smooth, gradual reduction in BP without affecting heart rate or cardiovascular reflexes. The antihypertensive effect begins within 2 hours, peaks around 6 hours, and lasts for at least 24 hours . In a retrospective cohort study, twice-daily dosing of lisinopril was associated with greater reductions in systolic BP compared to once-daily dosing, suggesting that dosing frequency can influence the extent of BP reduction .
Conclusion
Lisinopril is a highly effective antihypertensive agent that significantly lowers both systolic and diastolic blood pressure across various patient populations. Its dose-dependent efficacy, long-lasting effects, and favorable safety profile make it a valuable option for managing hypertension. Whether administered once or twice daily, lisinopril consistently demonstrates substantial BP reductions, contributing to better cardiovascular outcomes for patients.
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