First study to compare blood pressure lowering tablets, perindopril and lisinoril, and their effect on reducing mortality

This study investigated which blood pressure lowering drug, perindopril or lisinoril, is better at reducing the occurence of death caused by high blood pressure and heart problems over a 5 year period in patients with high blood pressure. 

Hypertension (high blood pressure) is a common medical condition where pressure in the blood vessels is too high. Uncontrolled high blood pressure causes the heart to have to work harder in order to pump blood. Over time, this added workload on the heart causes the heart to weaken resulting in complications such as abnormal heart rhythm, heart attack, or sudden loss of heart function (cardiac arrest).

Several different drugs reduce high blood pressure including angiotensin-converting enzyme (ACE) inhibitors such as perindopril (Aceon) or lisinoril (Zestril). These drugs prevent blood vessels from narrowing and thereby reduce high blood pressure. 

This study compared the effect of perindopril and lisinoril in reducing the occurence of death caused by heart problems among patients with high blood pressure. 

A total of 15,622 patients were newly prescribed ACE inhibitors for high blood pressure and were followed up for 5 years. The occurrence of death caused by heart problems such as heart attack, heart failure, and stroke were compared between the two drugs.

The study found that lisinopril users had a higher occurrence of death caused by heart-related problems (6.5% of patients) compared to perindopril users, of which 5.6% died of heart related problems. Overall, lisinopril users were 18% more likely to die from heart-related problems. However, it was found that this difference was only significant among patients aged >70 years. 

Perindopril was shown to be better at reducing the occurrence of heart-related death in patients with high blood pressure aged >70 years, compared to lisinopril.

This study was carried out among a Chinese population, and therefore the effect of perindopril  and lisinoril cannot necessarily be generalised for all other ethnicities. 

If you or someone you know have high blood pressure, talk to a doctor about the benefits of ACE inhibitors, in particular perindopril.