ASSESSMENT OF ANTIHYPERTENSIVE EFFECT BY BLOOD-PRESSURE MONITORING - APPLICATIONS TO BISOPROLOL AND LISINOPRIL IN A DOUBLE-BLIND-STUDY

The aim of this study was to evaluate the antihypertensive effect of d rugs according to the initial ambulatory blood pressure (BP) level. Af ter a 15-day placebo run-in period, 105 patients with moderate essenti al hypertension (mean age, 52 years) underwent 24-h BP monitoring (spa celabs: 1 measure/15 min). Patients were subdivided into two groups: t he ''High'' group, with 24-h mean values of systolic BP (SBP) > 137 or diastolic BP (DBP) > 87 mm Hg, and the ''Low'' group, with SBP less t han or equal to 137 and DBP less than or equal to 87 mm HE. All patien ts received, in a random and double-blind design, either bisoprolol (1 0 mg q.d.) or lisinopril (20 mg q.d.) for 8 weeks. At the end of this active treatment period, office and ambulatory BP measurements were pe rformed. Casual measurements revealed similar BP decreases in all subg roups receiving bisoprolol and lisinopril; BP monitoring showed that t he antihypertensive effect depended on the baseline mean 24-h value; - 15/-12 mm Hg for bisoprolol and -18/-13 mm Hg for lisinopril in the Hi gh group; -7/-6 mm Hg for bisoprolol and -6/-6 mm Hg for lisinopril in the Low group. This study shows that the antihypertensive effect depe nded on initial ambulatory BP values, with a lower BP decrease in the Low group. Assessment of the antihypertensive effect on ambulatory BP is useful in clinical trials.