EFFECT OF ALACEPRIL ON 24-HOUR BLOOD-PRESSURE IN ELDERLY HYPERTENSIVEPATIENTS

The effect of administration of an angiotensin-converting enzyme inhib itor, alacepril, on 24-hour blood pressure in tile elderly hypertensiv e patients was investigated. Thirteen elderly hypertensive patients (m ean age 71 +/- 5; 6 male and 7 female) participated in the present stu dy. After 2 weeks of control period alacepril was administered 25 - 50 mg/day for 8 weeks, Ambulatory blood pressure monitoring with cuff-os cillometric method was performed at the end of both control and treatm ent periods. Alacepril administration for weeks significantly decrease d 24-hour blood pressure while it had little effect on heart rate, Day time blood pressure was significantly decreased from 154 +/- 10/91 +/- 5 mmHg to 145 +/- 8/85 +/- 5 mmHg, while the change in nocturnal bloo d pressure was not significant, from 137 +/- 17/79 +/- 7 mmHg to 130 /- 15/75 +/- 9 mmHg. Hyperbaric area of systolic blood pressure was al so significantly decreased (from 295 +/- 185 mmHg x hour/day to 172 +/ - III mmHg x hour/day), indicating that pressure load to the heart was effectively reduced, Administration of alacepril did not cause tachyc ardia in response to the decrease in blood pressure. Acrophase of both blood pressure and heart rate was changed to 11:00 a,m. These finding s indicate that blockade of the renin-angiotensin system in rile elder ly hypertensive parients decreased blood pressure effectively without causing tachycardia or deterioration of diurnal variations of blood pr essure. These hemodynamic changes produced by alacepril administration are favorable for the treatment of the elderly patients with cardiova scular disease.