EVALUATION OF THE DURATION OF ACTION OF T RANDOLAPRIL BY AMBULATORY BLOOD-PRESSURE MONITORING

The duration of the antihypertensive action of trandolapril, a new ang iotensin converting enzyme inhibitor was studied in 23 patients using ambulatory blood pressure monitoring (ABPM) over 48 hours. After a 20- day placebo period (D1 to D20), mild to moderate hypertensive patients received 2 mg trandolapril once daily for 30 days (D21 to D50). The f irst 24-hour ABPM recording was performed on day 14, during the placeb o run-in period. Two additional recordings were done successively on d ays 50 and 51 corresponding to a normal dosing day and a following day with a simulated missed dose, respectively. The three blood pressure recordings (placebo, treatment, missed dose) were compared. The averag e 24-hour systolic (SBP) and diastolic (DBP) blood pressure were signi ficantly decreased by trandolapril. The mean +/- s.d. decrease between day 14 and day 50 were - 8.0 +/- 7.2 mmHg for the DBP and - 13.3 +/- 7.8 mmHg for the SBP. Blood pressure was also consistently decreased d uring the daytime period (- 8.7 +/- 7,9 mmHg for the DBP and - 15.6 +/ - 8.5 mmHg for the SBP), nighttime period (- 5.6 +/- 9.1 mmHg for the DBP and - 8.5 +/- 11.3 mmHg for the SBP) and early morning (- 12.3 +/- 9.7 mmHg for the DBP and - 15.9 +/- 15.1 mmHg for the SBP). The norma l circadian pattern of blood pressure was maintained under treatment. The antihypertensive effect of trandolapril was sustained beyond 24 ho urs after the last intake : there were no significant difference betwe en days 50 and 51 in terms of 24-hour, daytime and nighttime average b lood pressure. However, a wearing-off of the effect was observed in th e early morning period of day 51 : DBP D51 - DBP D50 = 4.0 +/- 8.6 mmH g - p < 0.05). In conclusion, a single daily dose of 2 mg of trandolap ril, decreased systolic and diastolic blood pressure, for more than 24 hours.