TROUGH TO PEAK RATIO OF ONCE-DAILY LISINOPRIL AND TWICE-DAILY CAPTOPRIL IN PATIENTS WITH ESSENTIAL-HYPERTENSION

The objective of this study was to assess the antihypertensive effect and the trough to peak (T:P) ratio of lisinopril and captopril, in pat ients with essential hypertension. After 2 weeks of placebo, 69 of 115 eligible patients had office diastolic blood pressure (DBP) between 9 0 and 114 mm Hg and daytime average DBP above 85 mm Hg during a 25-h a mbulatory BP monitoring (ABPM) and were randomised to receive lisinopr il (20 mg once daily) or captopril (50 mg twice daily) for 4 weeks. Of fice and ambulatory BP were then repeated. Indices of 24-h BP and T:P ratios were calculated and compared. Both drugs significantly reduced both office and ambulatory BP. The final BP obtained with lisinopril w as less than with captopril. On office measurement, 75% of the patient s treated with lisinopril and 44% on captopril were controlled (P < 0. 001), but responses by ABPM were not significantly different. T:P rati os calculated in all patients were 0.75 and 0.66 for lisinopril and ca ptopril respectively, but in patients who responded to each drug the c orresponding ratios were 0.78 and 0.73. In conclusion both 20 mg once- daily lisinopril and 50 mg captopril twice-daily achieve a favourable T:P ratio in patients with essential hypertension.