Duration of the antihypertensive action of atenolol, enalapril and placebo: a randomized within-patient study using ambulatory blood pressure monitoring.
Atenolol (A) and enalapril (E), two agents widely used as first-line monotherapy in arterial hypertension, have never been compared in their potency and duration of action by using 24-h ambulatory blood pressure monitoring (ABPM). Twelve out-patients (mean age 48.6 years - SD 7) with mild-to-moderate hypertension and supine diastolic blood pressure (Hawksley Random Zero Manometer) greater than 100 mmHg at the end of a 3-week placebo wash-out received, in double-blind and random order, A 100 mg daily, E 20 mg daily and placebo for 4 weeks each, according to a 3 x 3 latin square design. A 24-hour non-invasive ABPM (Spacelabs ICR 5200) was performed at the end of each of the 3 periods. In respect to placebo, both A and E produced a 24-h antihypertensive effect. The frequency of diastolic blood pressure values above 90 mmHg was 50.0% after placebo, 24.5% after A and 28.9% after E (a 51% reduction after A and a 42.3% reduction after E in respect to placebo - both p less than .05). Systolic blood pressure profiles differed less than 5 mmHg between placebo and A, as well as between placebo and E, between 9:30 and 10:30. Diastolic blood pressure profiles differed less than 5 mmHg between placebo and A over 2 h (between 2:30 and 3:30, and between 10:30 and 11:30), and between placebo and E over 2 other h (between 9:30 and 10:30, and between 11:30 and 12:30). None of the routine hematochemical parameters differed between placebo, A and E.(ABSTRACT TRUNCATED AT 250 WORDS)
Verdecchia
P
P
Department of Internal Medicine, Civic Hospital G. Villa, Perugia, Italy.
Gatteschi
C
C
Benemio
G
G
Boldrini
F
F
Guerrieri
M
M
Porcellati
C
C
D000328:Adult; D001262:Atenolol / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000379:methods; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004656:Enalapril / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011897:Random Allocation
D001262:Atenolol; D004656:Enalapril