Key result
Once-daily lisinopril monotherapy reduced mean 24-hour systolic/diastolic blood pressure from 150/98 mmHg at baseline to 132/86 mmHg with preserved circadian rhythm.
Why the study?
Does once-daily lisinopril monotherapy reduce 24-hour ambulatory blood pressure in Chinese patients with mild to moderate hypertension?
Does once-daily lisinopril monotherapy reduce 24-hour ambulatory blood pressure in Chinese patients with mild to moderate hypertension?
Once-daily lisinopril monotherapy effectively reduces 24-hour ambulatory blood pressure while preserving circadian rhythm in patients with mild to moderate hypertension.
Answers are grounded in this paper and cite their sources.
May support once-daily lisinopril in Chinese patients with mild-moderate hypertension; extends evidence but remains hypothesis-generating pending RCTs.
Lisinopril is a new, long‐acting angiotensin‐converting enzyme inhibitor formulated for once‐daily treatment of hypertension. This study assessed the 24‐h efficacy and tolerability of lisinopril in Chinese patients with mild to moderate hypertension of World Health Organization Stages I to II. A total of 30 patients aged 30 to 60 years (mean 47 ± 9) entered a 2‐week washout period. All patients had ambulatory diastolic blood pressure (BP) > 90 mmHg and were given active treatment with lisinopril for 4 to 7 weeks. The dose of lisinopril was titrated from 10 to 40 mg daily (at 8‐9 A. M.). In each patient, 24‐h ambulatory blood pressure (BP) monitoring (SpaceLabs 90202) was performed twice, once before and once following treatment. Mean 24‐hour systolic/diastolic BPs after lisinopril were significantly decreased compared with baseline values (132 ± 12/86 ± 7 vs. 150 ± 11/98 ± 7 mmHg; p < 0.0005/ 0.0005). The average dose of lisinopril was 14.5 ± 5 mg daily after a titration period of 5 weeks of treatment. Mean daytime (6 A. M. to 6 P. M.) BP decreased from 152 ± 11/100 ± 8 to 134 ± 12/87 ± 8 mmHg (p < 0.0005/0.0005) and nighttime (6 P.M. to 6 A. M.) BP from 147 ± 14/95 ± 9 to 128 ± 14/83 ± 8 mmHg ( p < 0.0005/0.0005). BP reduction was more pronounced during the night. Before treatment, the circadian variation showed a peak BP at 11 A. M. and nadir at 3 P. M. After treatment, significant BP reduction (p < 0.0005/0.0005) was seen throughout the 24‐h period. The circadian rhythm of BP was preserved as indicated by similar BP standard deviations (14 ± 3/11 ± 2 vs. 13 ± 3/10 ± 2 mmHg). Mean heart rate increased from 76 to 80 beats/min (p < 0.05). Four patients reported having a nonproductive cough. Thus, lisinopril administered as once‐daily monotherapy provided effective BP control over a 24‐h period with preserved circadian rhythm.
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Hwang et al. (1993) studied Mild to moderate systemic hypertension (n=30). Lisinopril vs. Baseline (pre-treatment) was evaluated on Mean 24-hour systolic/diastolic blood pressure (Decreased from 150 ± 11/98 ± 7 mmHg to 132 ± 12/86 ± 7 mmHg, p=<0.0005). Once-daily lisinopril monotherapy reduced mean 24-hour systolic/diastolic blood pressure from 150/98 mmHg at baseline to 132/86 mmHg with preserved circadian rhythm.
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