Is 10 milligrams (mg) of Lisinopril (Zestril) effective for treating hypertension?

From the Guidelines

Lisinopril at a dose of 10mg can be an effective initial treatment for hypertension, but its effectiveness may vary depending on individual patient factors, and dose adjustments may be necessary to achieve optimal blood pressure control, as recommended by the 2024 ESC guidelines for the management of elevated blood pressure and hypertension 1.

Key Considerations

• The medication works by inhibiting the angiotensin-converting enzyme, leading to vasodilation and reduced blood pressure, which contributes to its therapeutic effects in cardiovascular conditions.
• Factors such as age, kidney function, and severity of the condition can influence the medication's effectiveness at this dose.
• Regular monitoring and potential dose adjustments under medical supervision are crucial to ensure optimal treatment outcomes.

Recommended Approach

• According to the 2024 ESC guidelines, ACE inhibitors, such as Lisinopril, are recommended as first-line treatments for hypertension, along with ARBs, dihydropyridine CCBs, and diuretics 1.
• Combination therapy with two or more of these drug classes is recommended for most patients with confirmed hypertension, with the goal of achieving a blood pressure target of less than 130/80 mmHg 1.
• The guidelines also recommend fixed-dose single-pill combination treatment for patients receiving combination BP-lowering treatment, and suggest that spironolactone or eplerenone may be added to the treatment regimen if blood pressure is not controlled with a three-drug combination 1.

From the FDA Drug Label

An antihypertensive effect of lisinopril was seen with 5 mg of lisinopril in some patients However, in both studies blood pressure reduction occurred sooner and was greater in patients treated with 10 mg, 20 mg or 80 mg of lisinopril than patients treated with 5 mg of lisinopril.

The dose of 10 mg of Lisinopril is effective for treating hypertension, as it has been shown to produce a greater blood pressure reduction compared to 5 mg in clinical studies 2.

From the Research

Effectiveness of 10mg Lisinopril for Hypertension

• The provided studies do not specifically mention the effectiveness of 10mg of Lisinopril for treating hypertension 3, 4, 5, 6, 7.
• However, the studies suggest that Lisinopril is effective in lowering blood pressure in patients with hypertension, with dosages ranging from 2.5 to 80mg once daily 3, 4.
• One study mentions that many patients achieve an adequate blood pressure reduction with Lisinopril alone, and in those who do not, most will with the addition of hydrochlorothiazide 3.
• Another study notes that Lisinopril produces a smooth, gradual blood pressure reduction in hypertensive patients, with the antihypertensive effect beginning within 2 hours, peaking around 6 hours, and lasting for at least 24 hours 4.

Dosage and Efficacy

• The studies suggest that the efficacy of Lisinopril in reducing blood pressure is well established, but the optimal dosage for individual patients may vary 3, 4, 7.
• One study mentions that dosages effective in elderly patients tend to range from 2.5 to 40mg/day, with lower dosages usually needed in patients with significant renal impairment 7.
• Another study notes that high doses of Lisinopril (32.5 to 35mg, administered once daily) demonstrated clinically important advantages over low doses (2.5 to 5mg, administered once daily) in the treatment of congestive heart failure 6.

Safety and Tolerability

• The studies suggest that Lisinopril is well tolerated, with few serious adverse effects being reported 3, 4, 7.
• One study notes that the most common adverse events occurring in recipients of Lisinopril were dizziness, headache, hypotension, and diarrhea 6.
• Another study mentions that Lisinopril appears to reduce mortality in diabetic patients after myocardial infarction and may also improve neuropathy associated with diabetes, with a tendency for more elderly than younger patients to discontinue treatment 7.