Persistence of anti-hypertensive effect after missed dose of perindopril

Aims To assess the persistence of the antihypertensive effect of the ACE-in hibitor perindopril after one missed dose. Methods After a placebo run-in period, 10 hypertensive patients were starte d on perindopril 4 mg once daily in the morning, increased to 8 mg once dai ly after 4 weeks if office diastolic BP > 85 mmHg. 24 h BP monitoring was p erformed at the end of the placebo run-in period and during active treatmen t in week 9 and 10 on either active treatment or a placebo-day using a doub le-blind, randomized, crossover design. Results Office BP decreased from 155+/-3/100+/-2 mmHg at the end of placebo to 139 +/- 3/89 +/- 2 mmHg (P < 0.05 vs placebo) after 8 weeks of active t reatment. After 2 months of active treatment, 24 h ABP showed significant d ecreases in day BP by -11 +/- 1/-7 +/- 1 mmHg and in night BP by -11 +/- 2/ -7 +/- 1 mmHg while on active treatment. During the placebo-day, daytime BP showed decreases by -10 +/- 1/-5 +/- 1 and night BP by -8 +/- 2/-6 +/- 1 m mHg (NS vs active treatment day). Conclusions Perindopril 4-8 mg day(-1) causes a persistent decrease in BP d uring the 24 h dosing interval, which is mostly maintained over the 24-48 h after dosing.