24-H BLOOD-PRESSURE REDUCTION BY THE FIXE D COMBINATION OF RAMIPRIL AND PIRETANIDE

In a double-blind, randomised, multicenter 3-arm-study the ambulatory blood pressure monitoring (24-h-ABPM) was carried out in 106 hypertens ive patients (DBPdiast. > 95 mmHg) treated with the combination of pir etanide/ramipril or with either of the single substances. After a 4-we ek placebo period (single-blind) patients received for 8 weeks once da ily either 6 mg piretanide plus 5 mg ramipril in a fixed combination o r one of the substances. The daytime ABPM showed that the combination reduced blood pressure significantly (p < 0.005, unilateral) better th an piretanide treatment and more effectively than ramipril. The effect of the combination was superior both on the systolic and the diastoli c blood pressure. Moreover, blood pressure profile under the treatment with the combination was smoother than under monotherapy. Morning ris e in blood pressure was clearly weakened. There was no critical blood pressure drop during nighttime. Normalisation or improvement of blood pressure was achieved by piretanide in 74.3%, by ramipril in 85.3% and by the combination in 86.5% of the patients. There were no relevant l aboratory changes in the different treatment groups. Adverse events we re gently marked usually.