FOSINOPRIL IN THE TREATMENT OF HYPERTENSION - EFFECTS ON 24H AMBULATORY BLOOD-PRESSURE AND ON BLOOD-PRESSURE RESPONSE TO EXERCISE

This study evaluated the effects of medium-term once daily administrat ion of fosinopril (20 mg) on BP profile and on BP response to exercise in patients with mild to moderate hypertension. Twenty patients (14 m ales and 6 females; 25-57 years of age), after a six week drug wash-ou t phase, underwent 24h ambulatory BP monitoring (ABPM) (Spacelabs 9020 7) and, the day after, maximal bicycle exercise testing. Patients then received a once daily treatment with fosinopril and ABPM and exercise testing were repeated 45-60 days later. Fosinopril decreased average 24h SBP and DBP (-13.5 mmHg and -9.7 mmHg, respectively, P < 0.002); a significant BP reduction was observed both in day and in nighttime, w ithout alteration in diurnal BP profile. The antihypertensive effect w as still evident 24h after dosing. Trough to peak ratio was 0.58 +/- 0 .16. Fosinopril induced a reduction of SBP and DBP during exercise tes ting (-20 and -11 mmHg at baseline; -17 and -8 mmHg at peak exercise; -24 and -14 mmHg at the sixth minute of recovery; P < 0.002), with a s light prolongation of exercise time (+46 seconds, P = 0.041). These re sults indicate that fosinopril at a once daily dose of 20 mg provides a sustained 24h BP reduction associated with BP reduction during physi cal exercise. These effects have been obtained without altering diurna l BP profile, without excessive hypotension at the time of maximal ant ihypertensive effect and with a slight improvement of exercise toleran ce.