Is enalapril 10mg appropriate for hypertension with a blood pressure reading of 133/107?

Management of Hypertension with BP 133/107

Yes, enalapril 10mg is appropriate for your blood pressure of 133/107, as this reading indicates stage 2 hypertension requiring immediate pharmacological treatment. 1

Blood Pressure Classification and Assessment

Your blood pressure reading of 133/107 mmHg shows:

• Normal systolic BP (133 mmHg is <140)
• Significantly elevated diastolic BP (107 mmHg is >100)
• This classifies as stage 2 hypertension based on the diastolic value 1

Treatment Approach

Initial Medication Selection

• Enalapril (an ACE inhibitor) is an appropriate first-line agent for hypertension 1, 2
• For non-Black patients, ACE inhibitors like enalapril are recommended as initial therapy 1
• The standard dosage range for enalapril in hypertension is 10-40 mg daily 2

Dosing Considerations

• Your 10mg dose falls within the recommended range of 10-40 mg per day 2
• Enalapril can be administered as a single daily dose or divided into two doses 2
• If blood pressure control diminishes toward the end of the dosing interval, twice-daily administration may be considered 2

Monitoring and Follow-up

• After starting enalapril, you should have follow-up evaluation monthly until blood pressure control is achieved 1
• Target blood pressure should be <130/80 mmHg 1
• Blood pressure should be reduced by at least 20/10 mmHg; ideally to <140/90 mmHg initially 1

Important Precautions

• If you're currently taking a diuretic, be aware that symptomatic hypotension may occur with the initial dose of enalapril 2
• If possible, diuretics should be discontinued 2-3 days before starting enalapril to reduce the risk of hypotension 2
• Monitor for potential side effects including:
  • Cough (most common side effect of ACE inhibitors) 3
  • Dizziness, headache, and asthenia 4

Optimization Strategies

• If blood pressure is not adequately controlled with enalapril alone:
  • A thiazide diuretic may be added 1, 2, 3
  • Most patients achieve adequate blood pressure control with enalapril alone or with the addition of a thiazide diuretic 5
  • For stage 2 hypertension with BP >20/10 mmHg above target, combination therapy may be more effective 1

Special Considerations

• If you have renal impairment (creatinine clearance ≤30 mL/min), a lower initial dose of 2.5 mg would be recommended 2
• Avoid concomitant use of potassium supplements, potassium salt substitutes, or potassium-sparing diuretics as these may increase serum potassium levels 2

Remember to take your medication consistently and follow up with your healthcare provider to ensure your blood pressure is adequately controlled.