目的　以卡托普利作对照 ,观察咪达普利对Ⅰ～Ⅱ级原发性高血压降压治疗的有效性及安全性。方法　选择符合条件的原发性高血压 80例 ,随机分为A、B两组 ,A组 (n =4 0 )口服卡托普利片 2 5mgtid ;B组 (n =4 0 )每日晨起口服咪达普利片 5mg ,共 4周。分别记录用药前和用药后 1、2、3、4周的血压和心率 ,并比较用药前后的血、尿常规及生化指标 ,检查眼底、心电图、胸透以了解靶器官的受累情况。结果　A、B两组患者中 ,显效、有效及总有效率分别为 70 %、12 5 %、82 5 %和 72 5 %、12 5 %、85 %。A组治疗 2周后与B组治疗 1周后各时点血压值较治疗前均有显著下降 (P <0 0 5 )。服药 4周后 ,组间比较差异无显著意义 (P>0 0 5 ) ,两组治疗前后心率无明显变化 (P >0 0 5 )。不良反应发生率A组 10例 ,占 2 5 % ,B组 2例 ,占 5 %。结论　咪达普利治疗原发性高血压与 15倍剂量的卡托普利降压效果相近 ,且患者依从性好 ,安全性更高 Objective To use captopril as a control to observe the efficacy and safety of imidapril in the treatment of grade Ⅰ ~ Ⅱ essential hypertension. Methods Eighty eligible patients with essential hypertension were randomly divided into A and B groups. A group (n = 40) received 25 mg of captopril tablets per day; group B (n = 40) Starting oral imidapril tablets 5mg, a total of 4 weeks. The blood pressure and heart rate were recorded before and after 1, 2, 3, and 4 weeks respectively. The blood, urine and biochemical indexes before and after treatment were compared. Fundus, electrocardiogram and thoracoscopy were examined to understand the target organ involvement. Results The effective rate, effective rate and total effective rate in group A and B were 70%, 125%, 82%, 72%, 125% and 85% respectively. After 2 weeks of treatment in group A, the blood pressure of each group at 1 hour after treatment was significantly lower than that before treatment (P <0 05). Four weeks after taking the medicine, there was no significant difference between the two groups (P> 0.05). There was no significant difference in heart rate between the two groups before and after treatment (P> 0.05). The incidence of adverse reactions in group A 10 cases, 25%, B group 2 cases, 5%. Conclusion Imidapril treatment of essential hypertension and 15 times the dose of captopril antihypertensive effect is similar, and patients with good compliance, higher safety