A comparison of enalapril 20 mg once daily versus 10 mg twice daily in terms of blood pressure lowering and patient compliance

Objective To compare enalapril 20 mg once daily with 10 mg twice daily in terms of blood pressure reduction and patient compliance. Design Cross-over study of patients randomly assigned to a sequence of enalapril 20 mg once daily or 10 mg twice daily in three 4-week periods following a 4-week placebo run-in. Setting General practices in the greater Belfast and Lisburn area in Northern Ireland. Patients Twenty-five hypertensive patients who had a mean diastolic blood pressure of between 90 and 110 mmHg after receiving placebo for 4 weeks. Main outcome measures Reduction in blood pressure and estimation of patient compliance, Results Patient compliance was superior on the once daily regimen. However, the twice daily regimen was associated with a greater blood pressure reduction which almost reached statistical significance at the 5% level. Conclusions Enalapril 20 mg should be prescribed as 10 mg twice daily and measures taken to improve patient compliance. (C) Lippincott Williams & Wilkins.