Evaluation of antihypertensive effects of once‐a‐day isradipine and fosinopril: A double‐blind crossover study by means of ambulatory blood pressure monitoring

• Published in: Clinical cardiology (Mahwah, N.J.) Vol. 18; no. 7; pp. 401 - 407
• Main Authors: Perticone, Francesco, Pugliese, Fabiola, Marcantonio, Anna Maria, Cloro, Cosima, Maio, Raffaele, Mattioli, Pier Luigi
• Format: Journal Article
• Language: English
• Published: New York Wiley Periodicals, Inc 01.07.1995; Wiley
• Subjects: Administration, Oral; Adult; Aged; ambulatory blood pressure; Angiotensin-Converting Enzyme Inhibitors - administration & dosage; angiotensin‐converting enzyme inhibitors; Antihypertensive agents; Antihypertensive Agents - administration & dosage; antihypertensive therapy; Biological and medical sciences; Blood Pressure - drug effects; Blood Pressure Monitoring, Ambulatory; Calcium Channel Blockers - administration & dosage; calcium‐channel blockers; Cardiovascular system; Cross-Over Studies; Double-Blind Method; Female; fosinopril; Fosinopril - administration & dosage; Heart Rate - drug effects; Humans; hypertension; Hypertension - blood; Hypertension - drug therapy; Hypertension - physiopathology; isradipine; Isradipine - administration & dosage; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Hypertension; Calcium antagonist; Cardiovascular disease; Antihypertensive agent; Controlled therapeutic trial; Arterial pressure; Ambulatory; ACE inhibitor
• ISSN: 0160-9289; 1932-8737
• DOI: 10.1002/clc.4960180708

We compared the efficacy and tolerability of is‐radipine (ISR) and fosinopril (FOS) once‐a‐day administration in 17 outpatients, 9 men and 8 women, aged 35–65 years (mean ± SD= 58 ± 10 years), affected by mild to moderate primary systemic hypertension. The patients were given single‐blind placebo for 2 weeks and thereafter, in double‐blind, randomized, crossover sequence, ISR (5 mg) and FOS (20 mg), both for 4 weeks. At the end of each period, patients underwent 24‐h noninvasive blood pressure (BP) monitoring by means of an A&D TM 2420 Monitor Model 7, with readings taken every 10 min during the day (from 7 A.M. to 11 P.M.), and every 20 min during the night (from 11 P.M. to 7 A.M.). Similarly, BP load (BPL) as percentage of systolic and diastolic BP reading > 140 and > 90 mmHg was investigated. Both ISR and FOS induced a highly significant (p<0.0001) decrease in BP from 158/96 ± 7/6 mmHg to 133/86 ± 6/6 and to 132/83 ± 10/7 mmHg, respectively. Mean BP decreased from 117 ± 6 mmHg to 102 ± 6 mmHg (ISR) (p<0.0001) and to 99 ± 8 mmHg (FOS) (p<0.0001). Both ISR and FOS significantly (p<0.0001) reduced systolic BPL from 78 ± 16% to 44 ± 13% and 28 ± 12%, respectively, and diastolic BPL from 70 ± 15% to 40 ± 13% (p<0.0001) and 35 ± 13% (p<0.0001), respectively. A significant difference between the two drugs in systolic (p<0.0002) BPL was observed. No significant differences in heart rate were noted. No unexpected adverse effects were observed in any patient under either therapy. Both ISR and FOS resulted in very effective decrease in BP; however, FOS proved to be significantly more effective than ISR.