DIFFERENTIAL-EFFECTS OF A MISSED DOSE OF TRANDOLAPRIL AND ENALAPRIL ON BLOOD-PRESSURE CONTROL IN HYPERTENSIVE PATIENTS

被引：39

作者：

VAUR, L

DUTREYDUPAGNE, C

BOUSSAC, J

GENES, N

DYVOIRE, MB

ELKIK, F

MEREDITH, PA

机构：

[1] UNIV GLASGOW, WESTERN INFIRM, GARDINER INST, DEPT MED & THERAPEUT, GLASGOW G11 6NT, LANARK, SCOTLAND

[2] SOC EURAXI, TRUYES, FRANCE

[3] ROUSSEL, MED DEPT LABS, PARIS, FRANCE

来源：

JOURNAL OF CARDIOVASCULAR PHARMACOLOGY | 1995年 / 26卷 / 01期

关键词：

ACE INHIBITORS; MISSED DOSE; COMPLIANCE; ABPM;

D O I：

10.1097/00005344-199507000-00020

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A double blind randomised comparison of two angiotensin-converting enzyme (ACE) inhibitors was made in a study in which ambulatory blood pressure was monitored over a steady-state dosage interval and the subsequent 24-h period, the latter being designed to mimic a missed dose of drug. The blood pressure responses on active therapy were compared to an identical recording made at the end of a 3-week placebo run in period. Eighty-eight essential hypertensives were treated with a morning dose of either trandolapril 2 mg or enalapril 20 mg. Mean systolic (SEP) and diastolic blood pressure (DBP) were calculated on each of the following periods: daytime (8:31 a.m.-10:30 p.m.), nighttime (10:31 p.m.-6:30 a.m.), and early morning (6:31 a.m.-8:30 a.m.). Trough/peak was calculated for each group both on active treatment and after a missed dose. Twelve patients were excluded from analysis before opening the randomisation code because of inadequate ambulatory blood pressure monitoring (ABPM) recordings. Demographic data, placebo-period office blood pressure, and ABPM recordings were not significantly different between the two groups. Both trandolapril and enalapril effectively reduced blood pressure over the 24-h period. Twenty four-hour ambulatory SEP and DBP decreased from 148 +/- 14/92 +/- 10 mm Hg to 135 +/- 14/83 +/- 10 mm Hg in the trandolapril group (p < 0.001). The same parameters decreased to a quite similar extent after enalapril, from 143 +/- 13/91 +/- 5 mm Hg to 133 +/- 15/83 +/- 8 mm Hg (p < 0.001). The trough/peak ratio on active treatment was 90% (SBP) and 54% (DBP) in the trandolapril group and 49% (SBP and DBP) in the enalapril group. Following the missed dose, trough/peak ratio decreased to 58% (SBP)/36% (DBP) for trandolapril and 10% (SBP)/19% (DBP) for enalapril. The blood pressure control was better sustained with trandolapril, such that significant falls in blood pressure were observed during the daytime, nighttime and early morning periods after a missed dose, whereas during the same periods, enalapril only significantly reduced blood pressure in the daytime period.

引用

页码：127 / 131

页数：5

共 19 条

[1] Rose M., McMahon F.G., Some problems with antihypertensive drug studies in the context of the new guidelines, Am J Hyperlens, 3, pp. 151-155, (1990)
[2] Stokes G.S., Shenfield G.M., Johnston H.J., Marwood J.F., Dunagan F., Boutagy J., Timing of blood pressure measurements in determining anomalies in duration of effect of an antihypertensive drug: Assessment of isradipine, J Cardiovasc Pharmacol, 15, pp. S65-S69, (1990)
[3] Meredith P.A., Donnelly R., Elliott H.L., Howie C.A., Reid J.L., Prediction of the antihypertensive response to enalapril, J Hypertens, 8, pp. 1085-1090, (1990)
[4] Meredith P.A., ACE Inhibitors-concentration effect, dose response and duration of action in man, Current advances in ACE inhibition III
[5] Zannad F., Trandolapril: How does it differ from other angiotensin converting enzyme inhibitors?, Drugs, 46, pp. 172-182, (1993)
[6] Kruse W., Weber E., Dynamics of drug regimen compliance-its assessment by microprocessor-based monitoring, Eur J Clin Pharmacol, 38, pp. 561-565, (1990)
[7] Mallion J.M., Meilhac B., Tremel F., Calvez R., Bertholom N., Use of a microprocessor-equipped tablet box in monitoring compliance with antihypertensive treatment, J Cardiovasc Pharmacol, 19, pp. S41-S48, (1992)
[8] Guerviero D., Rudd P., Bryant-Kosling C., Middleton B.F., Antihypertensive medication taking-investigation of a simple regimen, Am J Hypertens, 6, pp. 586-592, (1993)
[9] Sullivan S.D., Kreling D.H., Hazlet T.K., Non-compliance with medication regimens and subsequent hospitalisations: A literature analysis and cost of hospitalisation estimate, J Res Pharmaceut Econ, 2, pp. 19-32, (1990)
[10] Psaty B.M., Koepsell T.D., Wagner E.H., LoGerfo J.P., Invi T.S., The relative risk of incident coronary heart disease associated with recently stopping the use of betablockers, JAMA, 263, pp. 1653-1657, (1990)

← 1 2 →