Abstract
Pharmacologic treatment of hypertension does not induce complete regression of cardiovascular risk, namely for a not satisfactory control of high BP. We evaluated 24-hour blood pressure control in a group of mild to moderate essential hypertensives during therapy with a fixed combination of hydrochlorothiazide and two different ACE-inhibitors (ramipril or captopril) administered chronically by at least six months. We evaluated hypotensive pharmacological control by 24-h ambulatory BP recording in 12 hypertensives (aged 33 to 77 years) during treatment with ramipril 5 mg / HCT 25 mg o.d. and in 10 hypertensives (aged 48 to 70 years) during treatment with captopril 50 mg / HCT 25 mg o.d. The office BP was well controlled in both groups: 132±4 / 84±3 mmHg (Ramipril/HCT) and 138±2 / 86±2 mmHg (Captopril/HCT), as well as 24-h ABPM (125±9 / 80±7 vs 128±9 / 81±5 mmHg, respectively), but daytime systolic BP maximum values were significantly lower during ramipril versus captopril (148±10 vs 160±8 mmHg at 11 a.m., p<0.008), while the daytime systolic BP minimum values were similar (111±10 vs 109±12 mmHg, at 3 p.m.). The difference between maximum-minimum systolic BP values were significantly lower during ramipril (38±11 versus 51±13 mmHg, p<0.017). Therefore, also the values of pulse pressure were significantly lower during ramipril (52,8±13,3 vs 64,2±9,3 mmHg, p<0.033). In conclusion, both ramipril/HCT and captopril/HCT induced an adequate control of high BP, but the peaks in systolic BP and in pulse pressure were lower during ramipril/HCT. (See Figure)
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© American Journal of Hypertension, Ltd. 2001
