What question did this study set out to answer?

To evaluate the administration-time-dependent effects of the long-acting ACE inhibitor spirapril on 48-hour ambulatory blood pressure in patients with uncomplicated essential hypertension.

April 1, 2010Chronobiology International

Administration-Time-Dependent Effects of Spirapril on Ambulatory Blood Pressure in Uncomplicated Essential Hypertension

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Why the study?

Does bedtime administration of spirapril improve ambulatory blood pressure control compared to morning administration in previously untreated hypertensive subjects?

Population

165 previously untreated hypertensive subjects, mean age 42.5 ± 13.9 years.

Comparison

Spirapril 6 mg/day monotherapy administered at… vs Spirapril 6 mg/day monotherapy administered upon…

Design

Cohort

Follow-up

12 weeks

Authors

RHRamón C. HermidaPreventive Cardiology DADiana E. AyalaPreventive Cardiology MFM. J. FontaoUniversidade de Vigo

Discussion

Member takes

Implication

Bedtime spirapril was associated with better ambulatory BP control; hypothesis-generating and requires randomized confirmation before practice change.

Key Points

To evaluate the administration-time-dependent effects of the long-acting ACE inhibitor spirapril on 48-hour ambulatory blood pressure in patients with uncomplicated essential hypertension.
Studied 165 previously untreated hypertensive patients (mean age 42.5 ± 13.9 years) assigned to receive spirapril monotherapy (6 mg/day) for 12 weeks either upon awakening or at bedtime.
Assessed blood pressure regulation using 48-hour ambulatory blood pressure monitoring before and after the 12-week intervention.
Both administration schedules produced similar reductions in blood pressure during daytime activity, but bedtime dosing was significantly more effective at lowering asleep blood pressure.
Bedtime spirapril increased the awake/asleep blood pressure ratio toward a normal dipping pattern and improved ambulatory blood pressure control from 23% to 59% (p < 0.001).

Structured PICO

Does bedtime administration of spirapril improve ambulatory blood pressure control compared to morning administration in previously untreated hypertensive subjects?

Population

165 previously untreated hypertensive subjects, mean age 42.5 ± 13.9 years.

Intervention

Spirapril 6 mg/day monotherapy administered at bedtime for 12 weeks.

Comparator

Spirapril 6 mg/day monotherapy administered upon awakening for 12 weeks.

Outcome

Ambulatory blood pressure (diurnal and asleep BP, awake/asleep BP ratio, and proportion of patients with controlled ambulatory BP) measured by 48-hour monitoring before and after treatment.surrogate

Bedtime administration of the long-acting ACE inhibitor spirapril significantly improves sleep-time blood pressure regulation and overall ambulatory blood pressure control compared to morning administration.

Cite This Study

Hermida et al. (2010) studied this question.

synapsesocial.com/papers/6a72dbf38084ee2b64303e43 https://doi.org/10.3109/07420528.2010.485411

Topics

Hypertension management Women and heart disease Cardiovascular prevention

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Implication

Bedtime spirapril was associated with better ambulatory BP control; hypothesis-generating and requires randomized confirmation before practice change.

Administration-Time-Dependent Effects of Spirapril on Ambulatory Blood Pressure in Uncomplicated Essential Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Administration-Time-Dependent Effects of Spirapril on Ambulatory Blood Pressure in Uncomplicated Essential Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider