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Cited by 158Blood Pressure and Hypertension StudiesSodium Intake and HealthRenin-Angiotensin System Studies

Lisinopril Versus Hydrochlorothiazide in Obese Hypertensive Patients: A Multicenter Placebo-Controlled Trial

Reisin, Efrain, Weir, Matthew R., Falkner, Bonita, Hutchinson, Howard G., Anzalone, Deborah A., Hypertension, Michael L. Tuck for the Treatment in Obese Patients With·1997·Hypertension
DOI 10.1161/01.hyp.30.1.140
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Abstract

Abstract Because obesity-associated hypertension has unique hemodynamic and hormonal profiles, certain classes of antihypertensive agents may be more effective than others as monotherapy. Thus, we compared the efficacy and safety of the angiotensin-converting enzyme inhibitor lisinopril and the diuretic hydrochlorothiazide in a 12-week, multicenter, double-blind trial in 232 obese patients with hypertension. Patients with an office diastolic pressure between 90 and 109 mm Hg were randomized to treatment with daily doses of lisinopril (10, 20, or 40 mg), hydrochlorothiazide (12.5, 25, or 50 mg), or placebo. Mean body mass indexes were similar for all patients. At week 12, lisinopril and hydrochlorothiazide effectively lowered office diastolic (−8.3 and −7.7 versus −3.3 mm Hg, respectively; P <.005) and systolic (−9.2 and −10.0 versus −4.6 mm Hg, respectively; P <.05) pressures compared with placebo. Ambulatory blood pressure monitoring confirmed that lisinopril and hydrochlorothiazide effectively lowered 24-hour blood pressure compared with placebo ( P <.001). Significant dose-response differences were observed between treatments. Sixty percent of patients treated with lisinopril had an office diastolic pressure <90 mm Hg compared with 43% of patients treated with hydrochlorothiazide ( P <.05). Responses to therapies differed with both race and age. Neither treatment significantly affected insulin or lipid profiles; however, plasma glucose increased significantly after 12 weeks of hydrochlorothiazide therapy compared with lisinopril (+0.31 versus −0.21 mmol/L; P <.001). Hydrochlorothiazide also decreased serum potassium levels by 0.4 mmol/L from baseline. In conclusion, lisinopril was as effective as hydrochlorothiazide in treating obese patients with hypertension. Treatment with angiotensin-converting enzyme inhibitors may show greater efficacy as monotherapy at lower doses compared with thiazide diuretics, may have a more rapid rate of response, and may offer advantages in patients at high risk of metabolic disorders.

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Crossref · 10.1161/01.hyp.30.1.140

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  • Blockade of the RAAS with angiotensin II receptor blockers, ACE inhibitors, or renin inhibitors reduces blood pressure in patients with obesity and hypertension.

    “As mentioned above, blockade of the RAAS with AngII receptor blockers, angiotensin-converting enzyme (ACE) inhibitors or renin inhibitors reduces BP in patients with obesity and hypertension64–66.”

    From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [66]

  • Smaller clinical trials have clearly shown that angiotensin receptor blockers (ARBs), renin inhibitors, or angiotensin converting enzyme (ACE) inhibitors are effective in lowering BP in obese hypertensive patients.

    “Although smaller clinical trials have clearly shown that angiotensin receptor blockers (ARBs), renin inhibitors, or angiotensin converting enzyme (ACE) inhibitors are effective in lowering BP in obese hypertensive patients46–48, there have been no large-scale clinical studies comparing the effectiveness of RAAS blockers in obese and lean hypertensive patients.”

    From Obesity-Induced Hypertension: Interaction of Neurohumoral and Renal Mechanisms (2015) · cites this paper as [47]

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Authors
Reisin, E., Weir, M. R., Falkner, B., Hutchinson, H. G., Anzalone, D. A., & Hypertension, M. L. T. F. T. T. I. O. P. W.
Affiliations
Louisiana State University (US)
ORCID
Falkner, Bonita
Venue
Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1997-07
Volume
30
Issue
1
Pages
140-145
ISSN
  • 0194-911X (ISSN-L)
  • 1524-4563
DOI
10.1161/01.hyp.30.1.140
OpenAlex
W2125280221
Cited by
158
References
23
Citations by year
2026: 4 · 2025: 4 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 9 · 2017: 4 · 2016: 5 · 2015: 6 · 2014: 5 · 2013: 7 · 2012: 5
FWCI
2.19
Type
journal article
Language
en
Open access
closed
Locations
  • Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Keywords
lisinopril, hydrochlorothiazide, obesity, ACE inhibitors, thiazide diuretics, antihypertensive monotherapy, blood pressure reduction, ambulatory blood pressure, dose-response relationship, plasma glucose, serum potassium
MeSH terms
Adult, Aged, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Data Interpretation, Statistical, Diuretics, Female, Humans, Hydrochlorothiazide, Hypertension, Male, Middle Aged, Obesity, Time Factors, Blood Pressure Monitors, Body Mass Index, Lisinopril, Sodium Chloride Symporter Inhibitors

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