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Impact of dosing time of quinapril on 24-hour hypotensive effect according to daily blood pressure profile in patients with primary hypertension
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Abstract
Material and methods The study included 60 patients (30 dipper and 30 non-dipper) with essential hypertension, aged 40.0 ± 15.7 years. After a week placebo run-in period patients received quinapril 10 mg. In case of ineffectiveness of treatment after 2 weeks the dose was doubled. After 4 weeks the dosing was changed into evening and then continued for the next 4 weeks. On consecutive visits office blood pressure measurement and 24-h ABPM were performed.
Results and conclusions The hypotensive effect of quinapril in office blood pressure measurements was greater and blood pressure variability (BPV) lower after the evening dosing, yet the differences observed in ABPM were not significant independently of the period of the day and the diurnal profile of BP assessed and seem to result from the difference in the antihypertensive effect only. In both dipper and non-dipper patients evening dosing of quinapril was more effective in sudden morning rise of SBP and DBP reduction. After quinapril treatment night blood pressure fall is increased independently of the dosing time. However, the day-night BP difference in nondipper patients is greater after the evening dosing. As a consequence, evening dosing of this ACEI restores normal diurnal BP rythm in higher percentage of patients.
Abstract
Material and methods The study included 60 patients (30 dipper and 30 non-dipper) with essential hypertension, aged 40.0 ± 15.7 years. After a week placebo run-in period patients received quinapril 10 mg. In case of ineffectiveness of treatment after 2 weeks the dose was doubled. After 4 weeks the dosing was changed into evening and then continued for the next 4 weeks. On consecutive visits office blood pressure measurement and 24-h ABPM were performed.
Results and conclusions The hypotensive effect of quinapril in office blood pressure measurements was greater and blood pressure variability (BPV) lower after the evening dosing, yet the differences observed in ABPM were not significant independently of the period of the day and the diurnal profile of BP assessed and seem to result from the difference in the antihypertensive effect only. In both dipper and non-dipper patients evening dosing of quinapril was more effective in sudden morning rise of SBP and DBP reduction. After quinapril treatment night blood pressure fall is increased independently of the dosing time. However, the day-night BP difference in nondipper patients is greater after the evening dosing. As a consequence, evening dosing of this ACEI restores normal diurnal BP rythm in higher percentage of patients.
Keywords
chronotherapy; dipper; non-dipper; blood pressure variability; night fall; morning surge; angiotensin-converting enzyme inhibitor
Title
Impact of dosing time of quinapril on 24-hour hypotensive effect according to daily blood pressure profile in patients with primary hypertension
Journal
Issue
Article type
Original paper
Pages
28-37
Published online
2008-01-28
Page views
682
Article views/downloads
909
Bibliographic record
Nadciśnienie tętnicze 2008;12(1):28-37.
Keywords
chronotherapy
dipper
non-dipper
blood pressure variability
night fall
morning surge
angiotensin-converting enzyme inhibitor
Authors
Arkadiusz Niklas
Katarzyna Kolasińska-Malkowska
Karolina Jankowska
Andrzej Tykarski