Twenty-four-hour antihypertensive efficacy of ramipril and enalapril

In a double-blind, randomized, crossover study, the antihypertensive efficacy of ramipril, a new angiotensin converting enzyme inhibitor, was compared with that of enalapril in 20 patients with mild hypertension. Patients underwent ambulatory blood pressure monitoring after a 4-week washout period and after 2 and 4 weeks of treatment. After 2 weeks of treatment, both ramipril and enalapril significantly reduced systolic (P < 0.03 and P < 0.002, respectively) and diastolic (P < 0.008 and P < 0.04, respectively) 24-hour blood pressures. No differences were found between treatments. After 4 weeks of treatment, both drugs continued to reduce 24-hour systolic (P < 0.002 and P < 0.03 for ramipril and enalapril, respectively) and diastolic blood pressures (P < 0.001 and P < 0.05 for ramipril and enalapril, respectively). The effect of ramipril on 24-hour blood pressure was greater than that of enalapril, but the differences did not reach statistical significance. These results demonstrate that the antihypertensive effects of ramipril and enalapril are comparable.