Document Detail

The response to the first dose of an angiotensin converting enzyme inhibitor in uncomplicated hypertension--a placebo controlled study utilising ambulatory blood pressure recording.
MedLine Citation:
PMID:  1777377     Owner:  NLM     Status:  MEDLINE    
1. The importance of total dose to the initial hypotensive response with an angiotensin converting enzyme inhibitor (quinapril) was assessed using a suggested 'maintenance' dose (20 mg) or matched placebo in a randomised double-blind study in patients with uncomplicated hypertension. 2. Thirty-two patients were recruited who were not on therapy or had not received diuretic therapy in their existing drug treatment in the preceding 4 weeks. Secondary causes of hypertension had previously been excluded and sustained clinic blood pressures of SBP greater than 160 mmHg and/or DBP greater than 90 mmHg were taken as indications for a trial of adjuvant or monotherapy with an ACE inhibitor. 3. After uneventful supervised therapy with quinapril in an open pilot study (n = 5) 27 patients entered a double-blind, randomised, crossover study of quinapril or placebo using ambulatory monitoring to assess BP response. 4. All patients remained asymptomatic and both therapy and monitoring were well tolerated. A smooth onset of antihypertensive effect was noted with an overall 24 h placebo corrected fall in systolic BP of 9.9 mmHg (7.2-12.6 95% CI) and diastolic BP of 6.4 mmHg (4.2-8.8) with no significant effect on heart rate. Individual placebo corrected maximal responses during the first 8 h following quinapril showed a wide range for both systolic (+1.56 to 44.0 mmHg) and diastolic (+2.3 to -35.6 mmHg) pressure. Larger falls tended to be associated with higher baseline pretreatment pressures but in no case did absolute systolic pressure fall below 100 mmHg during the first 8 h following administration of placebo or quinapril.(ABSTRACT TRUNCATED AT 250 WORDS)
R J MacFadyen; A D Bainbridge; K R Lees; J L Reid
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  British journal of clinical pharmacology     Volume:  32     ISSN:  0306-5251     ISO Abbreviation:  Br J Clin Pharmacol     Publication Date:  1991 Sep 
Date Detail:
Created Date:  1992-03-11     Completed Date:  1992-03-11     Revised Date:  2013-06-12    
Medline Journal Info:
Nlm Unique ID:  7503323     Medline TA:  Br J Clin Pharmacol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  393-8     Citation Subset:  IM    
University Department of Medicine and Therapeutics, Stobhill General Hospital, Glasgow.
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MeSH Terms
Angiotensin-Converting Enzyme Inhibitors*
Blood Pressure / drug effects*
Hypertension / drug therapy*
Isoquinolines / pharmacology*,  therapeutic use
Middle Aged
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Isoquinolines; 0/Placebos; 0/Tetrahydroisoquinolines; RJ84Y44811/quinapril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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