Comparison between enalapril and atenolol, administered as monotherapy or in combination with hydrochlorothiazide in mild to moderate hypertension of the elderly

Enalapril and atenolol were compared in a non-blind placebo controlled randomised study in 32 patients with mild to moderate hypertension aged 60-70 years. A four-week placebo run-in period was followed by 16 weeks of therapy. The initial doses were enalapril 10 mg or atenolol 50 mg. These were doubled if treatment was not effective after four weeks, and hydrochlorothiazide 25 mg was added to any nonresponder (D.B.P. > 95 mmHg). Systolic and diastolic blood pressure, both supine and standing, were significantly reduced in the two groups. The reduction of the standing SBP with enalapril was greater than with atenolol (p < 0.05). Except for unexplained hyperglycaemia during enalapril treatment, no difference in laboratory data was found and no significant side effects were observed. Enalapril is effective and well tolerated in elderly patients with mild to moderate hypertension.