open access

Vol 6, No 2 (2002)
Prace oryginalne
Published online: 2002-04-25
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Diurnal Blood Pressure Profile after the First Dose of Perindopril in Acute Myocardial Infarction in Patients with a History of Hypertension

Wojciech Sobiczewski, Andrzej Koprowski, Rafał Dworakowski, Adam Grzybowski, Krzysztof Chlebus, Bartosz Curyłło, Marcin Fijałkowski, Wiesław Puchalski, Leszek Mierzejewski, Andrzej Rynkiewicz
Nadciśnienie tętnicze 2002;6(2):113-122.

open access

Vol 6, No 2 (2002)
Prace oryginalne
Published online: 2002-04-25

Abstract

Background Indications for angiotensin converting enzyme (ACE) inhibitors are well established. Clinical trials revealed good tolerability of ACE inhibitors in patients with acute myocardial infarction, but there are data showing that selected groups of patients may be at risk of hypotension after the first dose of ACE inhibitor. The aim of our study was to evaluate blood pressure profile in early treatment with ACE inhibitor - perindopril in hypertensive patients with acute myocardial infarction.
Material and methods The study was performed in 72 consecutive patients with acute myocardial infarction (AMI), from which were selected patients with a history of hypertension. In a group of 20 hypertensive patients in control group blood pressure monitoring was performed in 1 or 2, or 3rd day of AMI, day before the beginning of ACE inhibitor therapy. In a group of 12 patients with hypertension in history perindopril was given in 1 or 2, or 3rd day of AMI, and blood pressure monitoring was performed. Non-invasive 24-hour ambulatory blood pressure monitoring was programmed to measure blood pressure every 20 minutes during a day and every 30 minutes at night.
Results Mean 24-hours systolic blood pressure was significantly lower in a group of patients with acute myocardial infarction and hypertension history after the first dose of 4 mg of perindopril (121,5 ± 11,1 mm Hg vs. 111,5 ± 9,4 mm Hg, p < 0,02). There was also significantly lower day SBP (123,3 ± 11,5 mm Hg vs. 112,6 ± 9,2 mm Hg, p < 0,01) and night SBP (116,4 ± 12,5 mm Hg vs. 106,8 ± 8,5 mm Hg, p < 0,03) in a group of patients treated with perindopril. There was no significant difference in diastolic blood pressure and heart rate between control group and group of patients treated with perindopril. In the perindopril group, the maximum decrease of mean one hour SBP compared to the first mean one hour SBP occurred 9 hours after the dose (14,2 ± 3,7 mm Hg vs. 7,0 ± 3,3 mm Hg, p < 0,001, in perindopril and control group respectively). Similarly estimated decrease in DBP was also lower in the perindopril group (8,9 ± 8,7 mm Hg) in comparison to control group (3,5 ± 3,1 mm Hg) (p < 0,001).
Conclusions Perindopril may cause significant blood pressure decrease after the first dose in patients with acute myocardial infarction and with a history of hypertension.

Abstract

Background Indications for angiotensin converting enzyme (ACE) inhibitors are well established. Clinical trials revealed good tolerability of ACE inhibitors in patients with acute myocardial infarction, but there are data showing that selected groups of patients may be at risk of hypotension after the first dose of ACE inhibitor. The aim of our study was to evaluate blood pressure profile in early treatment with ACE inhibitor - perindopril in hypertensive patients with acute myocardial infarction.
Material and methods The study was performed in 72 consecutive patients with acute myocardial infarction (AMI), from which were selected patients with a history of hypertension. In a group of 20 hypertensive patients in control group blood pressure monitoring was performed in 1 or 2, or 3rd day of AMI, day before the beginning of ACE inhibitor therapy. In a group of 12 patients with hypertension in history perindopril was given in 1 or 2, or 3rd day of AMI, and blood pressure monitoring was performed. Non-invasive 24-hour ambulatory blood pressure monitoring was programmed to measure blood pressure every 20 minutes during a day and every 30 minutes at night.
Results Mean 24-hours systolic blood pressure was significantly lower in a group of patients with acute myocardial infarction and hypertension history after the first dose of 4 mg of perindopril (121,5 ± 11,1 mm Hg vs. 111,5 ± 9,4 mm Hg, p < 0,02). There was also significantly lower day SBP (123,3 ± 11,5 mm Hg vs. 112,6 ± 9,2 mm Hg, p < 0,01) and night SBP (116,4 ± 12,5 mm Hg vs. 106,8 ± 8,5 mm Hg, p < 0,03) in a group of patients treated with perindopril. There was no significant difference in diastolic blood pressure and heart rate between control group and group of patients treated with perindopril. In the perindopril group, the maximum decrease of mean one hour SBP compared to the first mean one hour SBP occurred 9 hours after the dose (14,2 ± 3,7 mm Hg vs. 7,0 ± 3,3 mm Hg, p < 0,001, in perindopril and control group respectively). Similarly estimated decrease in DBP was also lower in the perindopril group (8,9 ± 8,7 mm Hg) in comparison to control group (3,5 ± 3,1 mm Hg) (p < 0,001).
Conclusions Perindopril may cause significant blood pressure decrease after the first dose in patients with acute myocardial infarction and with a history of hypertension.
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Keywords

acute myocardial infarction; 24-hour blood pressure monitoring; hypertension; perindopril

About this article
Title

Diurnal Blood Pressure Profile after the First Dose of Perindopril in Acute Myocardial Infarction in Patients with a History of Hypertension

Journal

Arterial Hypertension

Issue

Vol 6, No 2 (2002)

Pages

113-122

Published online

2002-04-25

Bibliographic record

Nadciśnienie tętnicze 2002;6(2):113-122.

Keywords

acute myocardial infarction
24-hour blood pressure monitoring
hypertension
perindopril

Authors

Wojciech Sobiczewski
Andrzej Koprowski
Rafał Dworakowski
Adam Grzybowski
Krzysztof Chlebus
Bartosz Curyłło
Marcin Fijałkowski
Wiesław Puchalski
Leszek Mierzejewski
Andrzej Rynkiewicz

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