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hypertension lisinopril tablets usp are indicated for the treatment of hypertension to lower blood pressure lowering blood pressure lowers the risk of fatal and non fatal cardiovascular events primarily strokes and myocardial infarctions these benefits have been seen in controlled trials of antihypertensive drugs from a wide variety of pharmacologic classes including lisinopril control of high blood pressure should be part of comprehensive cardiovascular risk management including as appropriate lipid control diabetes management antithrombotic therapy smoking cessation exercise and limited sodium intake many patients will require more than 1 drug to achieve blood pressure goals for specific advice on goals and management see published guidelines such as those of the national high blood pressure education program s joint national committee on prevention detection evaluation and treatment of high blood pressure jnc numerous antihypertensive drugs from a variety of pharmacologic classes and with different mechanisms of action have been shown in randomized controlled trials to reduce cardiovascular morbidity and mortality and it can be concluded that it is blood pressure reduction and not some other pharmacologic property of the drugs that is largely responsible for those benefits the largest and most consistent cardiovascular outcome benefit has been a reduction in the risk of stroke but reductions in myocardial infarction and cardiovascular mortality also have been seen regularly elevated systolic or diastolic pressure causes increased cardiovascular risk and the absolute risk increase per mmhg is greater at higher blood pressures so that even modest reductions of severe hypertension can provide substantial benefit relative risk reduction from blood pressure reduction is similar across populations with varying absolute risk so the absolute benefit is greater in patients who are at higher risk independent of their hypertension for example patients with diabetes or hyperlipidemia and such patients would be expected to benefit from more aggressive treatment to a lower blood pressure goal some antihypertensive drugs have smaller blood pressure effects as monotherapy in black patients and many antihypertensive drugs have additional approved indications and effects eg on angina heart failure or diabetic kidney disease these considerations may guide selection of therapy lisinopril tablets usp may be administered alone or with other antihypertensive agents heart failure lisinopril tablets usp are indicated as adjunctive therapy in the management of heart failure in patients who are not responding adequately to diuretics and digitalis acute myocardial infarction lisinopril tablets usp are indicated for the treatment of hemodynamically stable patients within 24 hours of acute myocardial infarction to improve survival patients should receive as appropriate the standard recommended treatments such as thrombolytics aspirin and beta blockers in using lisinopril tablets usp consideration should be given to the fact that another angiotensin converting enzyme inhibitor captopril has caused agranulocytosis particularly in patients with renal impairment or collagen vascular disease and that available data are insufficient to show that lisinopril tablets usp does not have a similar risk see warnings in considering the use of lisinopril tablets usp it should be noted that in controlled clinical trials ace inhibitors have an effect on blood pressure that is less in black patients than in non blacks in addition ace inhibitors have been associated with a higher rate of angioedema in black than in non black patients see warnings anaphylactoid and possibly related reactions
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