Germanò G, Damiani S, Germanò U, Pecchioli V, Pica B, Antonini P
VII Fisiopatologia Medica, Biometria, Università La Sapienza, Roma, Italia.
Nephron. 1990;55 Suppl 1:65-9. doi: 10.1159/000186038.
The extent and duration of the antihypertensive effect of enalapril and captopril, both given once daily, were evaluated in 12 mild-to-moderate essential hypertensives by 24-hour noninvasive blood pressure (BP) monitoring (Pressurometer IV-mod 1990-1991, Del Mar Avionics). Patients were randomized to a cross-over regimen either with enalapril, 10-20 mg, followed by captopril, 50-100 mg (first group), or with captopril followed by enalapril (second group). The dose was doubled if, at week 3 of each treatment, the diastolic BP remained at 90 mm Hg. Doubling of the 2 drugs was not required in 4 patients; in 7 patients the dose of both drugs was doubled; and in 1 patient the dose of only captopril was doubled. Two of the 7 patients who required doubling of both drugs were considered nonresponders to enalapril and captopril. The circadian rhythm was not altered by the treatments, and the drugs reduced BP mainly during the waking hours. However, the second peak of systolic BP in the late afternoon did not graphically appear to be modified by captopril administration. A periodic asymmetric model with 3 harmonics analysis carried out on 24-hour BP data justifies only the use of enalapril for once-daily administration.
通过24小时无创血压监测（Pressurometer IV-mod 1990 - 1991，德尔马航空电子设备公司），对12例轻度至中度原发性高血压患者评估了每日服用一次依那普利和卡托普利的降压效果程度和持续时间。患者被随机分为交叉治疗方案，一组先服用10 - 20毫克依那普利，随后服用50 - 100毫克卡托普利；另一组先服用卡托普利，随后服用依那普利。如果在每种治疗的第3周时舒张压仍保持在90毫米汞柱，则将剂量加倍。4例患者无需将两种药物加倍；7例患者两种药物的剂量均加倍；1例患者仅将卡托普利的剂量加倍。在需要将两种药物剂量均加倍的7例患者中，有2例被认为对依那普利和卡托普利无反应。治疗未改变昼夜节律，药物主要在清醒时间降低血压。然而，卡托普利给药后，下午晚些时候收缩压的第二个峰值在图表上似乎未被改变。对24小时血压数据进行的带有3个谐波分析的周期性不对称模型表明，仅依那普利适合每日一次给药。
