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

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