Time-dependent effects of imidapril administration in patients with morning hypertension measured as home blood pressure.
We investigated the effect of the timing of imidapril administration in patients with morning hypertension (home blood pressure [HBP] in the morning [morning HBP] > or =135/85 mmHg). Eighty-seven patients (mean age, 61 years; 48% women) with morning hypertension each measured HBP in the early morning, before going to bed for the final five days of the observation, and during treatment. Imidapril (2.5 or 5.0 mg) was administered once every morning (n = 57) or at bedtime (n = 30) for four weeks (monotherapy: n = 30, 34%; combined with other antihypertensive drugs: n = 57, 66%). The morning (M) versus evening (E) effect (M/E ratio) and the evening versus morning effect (E/M ratio) were calculated to assess the duration of imidapril action. Morning HBP was significantly reduced (all p < 0.05) except when 2.5 mg of imidapril was administered once at bedtime. The individual M/E ratios expressed as means +/- standard deviation for systolic HBP were 0.9 +/- 0.7 and 0.7 +/- 0.7 for the morning administration of 2.5 and 5.0 mg of imidapril, respectively. The corresponding E/M ratios for bedtime administration were 0.3 +/- 0.5 and 1.0 +/- 0.7, respectively. One daily dose of imidapril taken either in the morning or at bedtime lowered morning HBP, indicating that imidapril is useful for controlling morning hypertension.
Shibasaki
Takako
T
Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.
Obara
Taku
T
Ohkubo
Takayoshi
T
Hara
Azusa
A
Metoki
Hirohito
H
Inoue
Ryusuke
R
Asayama
Kei
K
Kikuya
Masahiro
M
Hashimoto
Junichiro
J
Totsune
Kazuhito
K
Imai
Yutaka
Y
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000379:methods*; D002940:Circadian Rhythm; D004334:Drug Administration Schedule; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D048289:Imidazolidines / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012648:Self Care; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D048289:Imidazolidines; C065166:imidapril