Palatini P, Racioppa A, Raule G, Zaninotto M, Penzo M, Pessina A C
Clinica Medica 1, University of Padova, Italy.
Clin Pharmacol Ther. 1992 Oct;52(4):378-83. doi: 10.1038/clpt.1992.158.
To assess whether timing of administration can influence the antihypertensive effect of quinapril, 18 patients with hypertension were studied with noninvasive ambulatory blood pressure monitoring. Quinapril, 20 mg, was given at 8 AM or 10 PM for 4 weeks in a double-blind crossover fashion. To study the pattern of angiotensin converting enzyme (ACE) inhibition with the two treatment regimens, plasma ACE activity was measured in seven subjects 2, 4, 8, 12 and 24 hours after quinapril administration. The 24-hour blood pressure profiles showed a more sustained antihypertensive action with the evening administration of quinapril compared with the morning administration of quinapril; as with the morning administration, a partial loss of effectiveness was observed during nighttime hours. Measurement of ACE activity showed that evening administration caused a less pronounced but a more sustained decline of plasma ACE. These findings show that 20 mg quinapril given once daily is effective in lowering blood pressure levels throughout a 24-hour period. The evening administration seems to be preferable because it causes a more favorable modulation of ACE inhibition and therefore determines a more homogeneous 24-hour blood pressure control.
为评估给药时间是否会影响喹那普利的降压效果，对18例高血压患者进行了无创动态血压监测研究。以双盲交叉方式，于上午8点或晚上10点给予20mg喹那普利，持续4周。为研究两种治疗方案下血管紧张素转换酶（ACE）抑制模式，在7名受试者服用喹那普利后2、4、8、12和24小时测量血浆ACE活性。24小时血压曲线显示，与上午服用喹那普利相比，晚上服用喹那普利具有更持久的降压作用；与上午服用一样，夜间观察到部分疗效丧失。ACE活性测量显示，晚上给药导致血浆ACE下降不太明显但更持久。这些发现表明，每日一次给予20mg喹那普利可有效降低24小时内的血压水平。晚上给药似乎更可取，因为它能更有利地调节ACE抑制，从而实现更均匀的24小时血压控制。
