Evaluation of 24-hour antihypertensive effect of ramipril (Polpril) in patients with essential mild/moderate arterial hypertension

Abstract

Background Clinical studies have demonstrated a different
effect on blood pressure of some angiotensin-converting
enzyme inhibitors when administered in the morning
versus the evening. ABPM can demonstrate the efficacy of
antihypertensive medication over a 24-hour period. The
ABPM can demonstrate a number of patterns of blood
pressure behaviour that may be relevant to clinical management
— dipping, non-dipping, morning surge and blood
pressure variability. Blood pressure variability (BPV) has
a strong prognostic correlation with cardiovascular events
and the development of target organ damage. Morning surge
is associated with hypertensive target organ damage and subsequent
cardiovascular risk in hypertensive patients.
The aim of the study was evaluation of ramipril dosing
once daily morning on 24-hour antihypertensive effect,
changes in “morning surge”, blood pressure variability and
night blood fall in patients with essential mild/moderate
arterial hypertension.

Material and methods 75 patients with primary, mildmoderate
arterial hypertension diagnosis based on traditional measurements were qualified for research. Antihypertensive
therapy was based on ramipril (5 mg daily).
After 4 weeks of antihypertensive therapy if SBP > 140
and/or DBP > 90 mm Hg, dose of ramipril was doubled.
ABPM were performed baseline and after 3 months active
treatment with ramipril.

Results We confirmed significant reduction of SBP and
DBP in 24-h using ABPM device. We did not observed
any negative influence of ramipril dosing once daily morning
on analysed parameters (morning surge, night blood
fall, variability of blood pressure).