[Comparative effects of angiotensin converting enzyme inhibitors and calcium antagonists on pulse pressure and blood pressure variability, based on ambulatory measurements in 236 mild to moderate hypertensive patients].
OBJECTIVE
this retrospective study was aimed: at comparing the effects of angiotensin converting enzyme inhibitors (ACEI) and those of calcium antagonists (CA) on the pulse pressure of mild to moderate hypertensive patients; at assessing whether these effects were associated with some modifications of blood pressure variability or not.


METHODS
the ambulatory blood pressure (ABP) recordings of 236 patients who previously entered clinical trials with a mean run-in placebo period of 2 weeks and a mean active treatment phase of 6 weeks (ACEI, n = 115; CA, n = 121) were reviewed. Baseline ABP has been analysed both as a continuous variable and as a categorical one (high when > 139/87 mmHg, low otherwise). Pulse pressure was calculated by the difference systolic ABP-diastolic ABP, whereas BP variability was estimated by the standard deviation and the variation coefficient of each recording. The results are given as percentage (mean +/- standard deviation). In the patients with high baseline systolic ABP, ACEI and CA did not significantly differ regarding their effects on pulse pressure (-11.1 +/- 17.2 vs -6.3 +/- 14.0, NS). By contrast, in the other patients, pulse pressure was lowered to a significantly greater degree by ACEI than by CA (-5.5 +/- 18.7 vs +1.8 +/- 18.8, p = 0.04). These differences were not related to baseline diastolic ABP. No difference at all was found with regard to BP variability which was altered by none of the drugs. In conclusion, pulse pressure, a reliable indicator of arterial compliance, seemed to be more decreased by ACEI than by CA, the difference being significant only in patients with apparent hypertension.
Herpin
D
D
Service de cardiologie B, CHU La Milétrie, Poitiers.
Vaïsse
B
B
Allavoine
T
T
Pitiot
M
M
de Gaudemaris
R
R
Mallion
J M
JM
Poggi
L
L
Demange
J
J
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000379:methods; D002121:Calcium Channel Blockers / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers
Effets comparés des inhibiteurs de l'enzyme de conversion et des inhibiteurs calciques sur la pression pulsée et la variabilité tensionnelle mesurées en ambulatoire chez 236 hypertendus légers à modérés.