Assessment of drug effects on blood pressure and pulse pressure using clinic, home and ambulatory measurements

This study investigated the differences in the effect of an angiotensin converting enzyme inhibitor (ACEI) compared with an angiotensin receptor blocker (ARB) on blood pressure (BP) and pulse pressure (PP) measured in the clinic (CBP and CPP, respectively), at home (HBP, HPP) and with ambulatory mon...

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Bibliographic Details
Published in:	Journal of human hypertension Vol. 16; no. 10; pp. 729 - 735
Main Authors:	STERGIOU, G. S, EFSTATHIOU, S. P, SKEVA, I. L, BAIBAS, N. M, KALKANA, C. B, MOUNTOKALAKIS, T. D
Format:	Journal Article
Language:	English
Published:	Basingstoke Nature Publishing 01-10-2002 Nature Publishing Group
Subjects:	Angiotensin Angiotensin-converting enzyme inhibitors Angiotensin-Converting Enzyme Inhibitors - therapeutic use Antihypertensive Agents - therapeutic use Antihypertensive drugs Antihypertensives Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Blood pressure Blood Pressure - drug effects Blood Pressure Determination - methods Blood Pressure Monitoring, Ambulatory Cardiology. Vascular system Clinical manifestations. Epidemiology. Investigative techniques. Etiology Control Cross-Over Studies Diagnosis Diuretics Dosage and administration Drug therapy Female Home Care Services Humans Hypertension Hypertension - drug therapy Lisinopril - therapeutic use Losartan - therapeutic use Male Measurement Medical sciences Office Visits Peptidyl-dipeptidase A Pulse Reproducibility of Results Risk factors Treatment Outcome Greece Human Hypertension pulse pressure angiotensin receptor blockers ambulatory pulse pressure angiotensin converting enzyme inhibitors Cardiovascular disease Exploration Chemotherapy Treatment Antihypertensive agent Arterial pressure Ambulatory Hemodynamics home blood pressure
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Summary:	This study investigated the differences in the effect of an angiotensin converting enzyme inhibitor (ACEI) compared with an angiotensin receptor blocker (ARB) on blood pressure (BP) and pulse pressure (PP) measured in the clinic (CBP and CPP, respectively), at home (HBP, HPP) and with ambulatory monitoring (ABP, APP). Twenty-seven hypertensive patients were randomised to receive lisinopril (20 mg) or losartan (50 mg) for 5 weeks, and were subsequently crossed-over to the alternative treatment for a second 5-week period. Measurements of CBP, 24-h ABP and 5-days HBP were performed before randomisation and at the end of each treatment period. All measurement methods showed that lisinopril was more effective than losartan in reducing BP. However, the difference between the two drugs was demonstrated with greater precision using HBP (P<0.001) than 24-h ABP (P<0.01), whereas the poorest precision for demonstrating this difference was provided by CBP (P<0.05). Lisinopril was also found more effective than losartan in reducing HPP (P=0.01) and 24-h APP (P=0.03) whereas no such a difference was detected using measurements of CPP. It was concluded that the antihypertensive drugs may differ in their effects not only on BP, but also on PP. HBP monitoring appears to be as reliable as 24-h ABP monitoring in detecting differences in the effect of drugs on both BP and PP. Clinic measurements seem to be the least reliable method, particularly in the detection of differences in PP.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0950-9240 1476-5527
DOI:	10.1038/sj.jhh.1001477