Trough:peak ratio of the blood pressure response to angiotensin converting enzyme inhibitors.
SHORT- VERSUS LONG-ACTING ANGIOTENSIN CONVERTING ENZYME (ACE) INHIBITORS: Although ACE inhibitors are widely used in the treatment of hypertension, there are few data on trough:peak ratios and the data are contradictory. Part of the explanation for this lies in differences in pharmacological properties. Depending on the kinetics of elimination, the trough:peak ratio of short- and long-acting ACE inhibitors has to be evaluated according to a dose regimen of twice or once a day, respectively, and must take account of the dose used, since long-acting ACE inhibitors appear to have a dose-dependent trough:peak effect. Further explanations for the contradictory trough:peak ratios reported for ACE inhibitors include measurement methods (clinic blood pressure versus ambulatory monitoring) and study design. TROUGH:PEAK RATIO: Data from randomly allocated, placebo-controlled studies indicate that both the short-acting ACE inhibitors captopril and quinapril given twice a day and the long-acting ACE inhibitors enalapril, lisinopril, benazepril and cilazapril given once a day have an acceptable trough:peak ratio (> 50%). The evidence suggests that when chemically different ACE inhibitors with similar kinetics of elimination are administered at equipotent doses, similar trough:peak ratios are obtained.
Salvetti
A
A
Department of Internal Medicine, Medical Clinic I, University of Pisa, Italy.
Di Venanzio
L
L
Arrighi
P
P
Arzilli
F
F
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000493:pharmacokinetics / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design
D000806:Angiotensin-Converting Enzyme Inhibitors