From the Guidelines
The most recent and highest quality study recommends that the diagnosis of hypertension should be based on repeated office blood pressure measurements on more than one visit, except when hypertension is severe, and out-of-office blood pressure measurement with ABPM and/or HBPM, if logistically and economically feasible 1. To determine the best course of action, it's essential to consider the context of the question.
Possible Interpretations
- If "Pres" refers to "prescription," the question might be asking about the best approach to managing hypertension, in which case the 2024 ESC guidelines recommend lifestyle changes and medication, if necessary, to control blood pressure 1.
- If "Pres" refers to "pressure," the question might be inquiring about blood pressure management, and the 2020 International Society of Hypertension global hypertension practice guidelines suggest measuring blood pressure in both arms and considering out-of-office measurements for diagnosis 1.
Key Considerations
- The diagnosis of hypertension should not be made on a single office visit, and out-of-office blood pressure measurements can help confirm the diagnosis 1.
- Lifestyle changes, such as diet and exercise, are essential for managing hypertension, and medication may be necessary to control blood pressure in some cases 1.
- It's crucial to consider the patient's individual needs and medical history when developing a treatment plan, and regular monitoring of blood pressure is necessary to adjust the treatment plan as needed 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Overview of Lisinopril
- Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used in the treatment of hypertension and congestive heart failure 2, 3.
- It is effective in lowering blood pressure in all grades of essential hypertension, and is at least as effective as other antihypertensive drugs such as hydrochlorothiazide, atenolol, and metoprolol 3, 4.
Mechanism of Action
- Lisinopril lowers arterial pressure by decreasing total peripheral resistance, maintaining or improving cardiac contractility, and promoting regression of left ventricular hypertrophy 2.
- It also increases renal blood flow, which can help to reduce renal vascular resistance and improve kidney function 2, 4.
Efficacy and Safety
- Studies have shown that lisinopril is effective in reducing blood pressure in patients with mild to moderate hypertension, and is well tolerated with few serious adverse effects 3, 4, 5.
- Lisinopril has also been shown to be safe and effective in elderly patients with mild to moderate hypertension, with a starting dose of 5 mg once daily 5.
Comparison with Other Treatments
- Lisinopril has been compared to other antihypertensive drugs, including hydrochlorothiazide, atenolol, and metoprolol, and has been shown to be at least as effective in reducing blood pressure 3, 4.
- Combination therapy with lisinopril and hydrochlorothiazide has been shown to be more effective than monotherapy with either drug alone in reducing blood pressure 4.