[Evaluation of captopril-enalapril replacement therapy in hypertensive patients under ambulatory blood pressure monitoring].
Authors performed a comparative study of replacement of captopril (2-3x daily) therapy with once daily enalapril. Blood pressure was measured by 24-hour ambulatory monitoring. The study enrolled 62 patients with mild to moderate hypertension. Captopril was previously administered 2-4 times per day, in mean dose of 74.4 mg, for 3.2 years as an average. After a 4 x 4 weeks study period the final enalapril dose was 15 mg, once in the morning. Enalapril was administered as monotherapy in 36 cases. During the trial mean blood pressure decreased from 140 +/- 14/85 +/- 9 mmHg to 125 +/- 12/76 +/- 7 mmHg (p < 0.01), diurnal index increased from 12/10% to 15/11%. Enalapril treatment lowered daytime percent time elevation index (PTI) from 56 +/- 30% to 27 +/- 23% (p < 0.05), nighttime PTI from 64 +/- 34% to 37 +/- 35% (p < 0.05), and hyperbaric impact values from 183 +/- 152 mmHg x hour to 97 +/- 128 mmHg x hour (p < 0.01). Adverse effects of both drugs were rare and mild, enalapril caused no changes in overall quality of life. Improvement of antihypertensive efficacy after a switch to enalapril treatment could be related to better compliance achieved by once-daily dose, and tight out-patient blood pressure control. The authors concluded that after a 16 weeks of therapy, once-daily enalapril administration was more effective and compliant in reducing blood pressure, than 2-4 times per day captopril treatment, when measured by 24-hour ambulatory blood pressure monitoring.
Jahn Ferenc Kórház I. sz. Belgyógyászati Osztály, Budapest.
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Ruszty
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Hidas
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Iványi
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Dudás
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Molnár
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018660:Blood Pressure Monitoring, Ambulatory; D002216:Captopril / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004656:Enalapril; D002216:Captopril