Application of ambulatory blood pressure monitoring to clinical therapeutic decisions in hypertension

Whelton, A.

Journal of Hypertension. Supplement Official Journal of the International Society of Hypertension 9(1): S21-S25

1991


ISSN/ISBN: 0952-1178
PMID: 1645768
Document Number: 379949
The antihypertensive efficacies of lisinopril and captopril were compared using office sphygmomanometry and 24-h ambulatory blood pressure monitoring. In a double-blind, prospective, randomly allocated trial, the patients were given increasing doses of captopril at 25-100 mg twice a day or lisinopril at 10-40 mg once a day until a clinical response was achieved or the highest dose was reached. A response was defined as a reduction in diastolic pressure below 90 mmHg or a fall of at least 10 mmHg from baseline. The ambulatory monitoring showed that lisinopril reduced blood pressure from baseline to the final value and maintained the reduction to a greater degree than captopril throughout 24-h periods of observation. The office measurements showed a similar trend, but the intertreatment differences did not reach statistical significance. No first-dose side effects were observed with either drug. Once a day lisinopril appeared to be a more effective antihypertensive regimen than twice a day captopril.

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