Application of ambulatory blood pressure monitoring to clinical therapeutic decisions in hypertension.
The antihypertensive efficacies of lisinopril and captopril were compared using office sphygmomanometry and 24-h ambulatory blood pressure monitoring. In a double-blind, prospective, randomly allocated trial, the patients were given increasing doses of captopril at 25-100 mg twice a day or lisinopril at 10-40 mg once a day until a clinical response was achieved or the highest dose was reached. A response was defined as a reduction in diastolic pressure below 90 mmHg or a fall of at least 10 mmHg from baseline. The ambulatory monitoring showed that lisinopril reduced blood pressure from baseline to the final value and maintained the reduction to a greater degree than captopril throughout 24-h periods of observation. The office measurements showed a similar trend, but the intertreatment differences did not reach statistical significance. No first-dose side effects were observed with either drug. Once a day lisinopril appeared to be a more effective antihypertensive regimen than twice a day captopril.
Whelton
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Johns Hopkins Hospital, Baltimore, Maryland 21205.
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination / Q000295:instrumentation; D015924:Blood Pressure Monitors; D002216:Captopril / Q000627:therapeutic use*; D002940:Circadian Rhythm / Q000502:physiology; D004311:Double-Blind Method; D004656:Enalapril / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D017706:Lisinopril; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000959:Antihypertensive Agents; D004656:Enalapril; D002216:Captopril; D017706:Lisinopril